Clinical outcomes, when matched at presentation, do not vary between adult-onset Henöch-Schönlein purpura nephritis and IgA nephropathy

Hyung Jung Oh, Song Vogue Ahn, Dong Eun Yoo, Seung Jun Kim, Dong Ho Shin, Mi Jung Lee, Hyoung Rae Kim, Jung Tak Park, Tae Hyun Yoo, Shin Wook Kang, Kyu Hun Choi, Seung Hyeok Han

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49 Scopus citations

Abstract

Henöch-Schönlein purpura nephritis (HSPN) is considered a systemic form of immunoglobulin A nephropathy (IgAN). Although these are different pictures of a single disease, there are no studies directly comparing long-term outcomes of these two clinical entities. To clarify this, we studied 120 patients with biopsy-proven HSPN and 1070 patients with IgAN. The primary outcome was the composite of a doubling of baseline serum creatinine, end-stage renal disease, or death. Secondary outcomes included the individual renal outcomes or the rate of decline in estimated glomerular filtration rate. In the unmatched cohort, patients with HSPN had more vasculitic symptoms, more favorable histologic features, and were more commonly treated with steroids than patients with IgAN. The risk of reaching the primary outcome was significantly lower in HSPN patients than patients with IgAN (hazard ratio, 0.67). The 1:2 propensity score matching gave matched pairs of 89 patients with HSPN and 178 patients with IgAN, resulting in no differences in baseline conditions. In this matched cohort, there were no significant differences in reaching the primary and secondary outcomes between the two groups. Thus, after adjustment by propensity score matching, clinical outcomes did not differ between HSPN and IgAN, suggesting the two forms of the same disease have a similar prognosis.

Original languageEnglish
Pages (from-to)1304-1312
Number of pages9
JournalKidney International
Volume82
Issue number12
DOIs
StatePublished - 2 Dec 2012

Bibliographical note

Funding Information:
This study was supported by a faculty research grant of Yonsei University College of Medicine for 2012 (6-2012-0033); and by a grant of the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (A102065).

Keywords

  • HSP nephritis
  • IgA nephropathy
  • clinical outcomes

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