Prognostic implications of normal or minimal urinary findings on long-term renal impairment in adults with Henoch-Schönlein purpura
| Autor: | Emily Baumrin, Jessica St. John, Daniela Kroshinsky, Camden P. Bay, Steven T. Chen, Mai P. Hoang, Soraya Azzawi |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Henoch-Schonlein purpura IgA Vasculitis Urinary system Population Dermatology Urinalysis Kidney urologic and male genital diseases Gastroenterology Cohort Studies 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Interquartile range Internal medicine medicine Humans education Aged Retrospective Studies education.field_of_study Proteinuria business.industry Hazard ratio Retrospective cohort study Middle Aged Prognosis medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis Female Kidney Diseases medicine.symptom business |
| Zdroj: | Journal of the American Academy of Dermatology. 82:1393-1399 |
| ISSN: | 0190-9622 |
| Popis: | Background Renal involvement in adult Henoch-Schonlein purpura is a major cause of morbidity and can lead to significant long-term renal impairment. The prognostic significance of normal or minimal urinary abnormalities at diagnosis is unknown. Objective To assess the risk of long-term renal impairment in patients with Henoch-Schonlein purpura who present with normal or minimal urinary abnormalities. Methods Retrospective cohort study of adult Henoch-Schonlein purpura patients presenting with normal urinalysis results, microscopic hematuria, or low-grade proteinuria. Patients were followed for development of long-term renal impairment, with adjusting for comorbidities. Results Forty-seven patients were included, with median follow-up 73.9 months (interquartile range 35 to 98 months). Thirty-nine patients (83.0%) had abnormal urinalysis results, of whom 15 (38.5%) progressed to long-term renal impairment. In contrast, 8 patients (17%) had normal urinalysis results, of whom only 1 (12.5%) developed long-term renal impairment (adjusted hazard ratio 10.58; 95% confidence interval 1.18-94.73). Renal events occurred at a median 36.1 months (interquartile range 17.1 to 61 months) from diagnosis, earlier in patients with comorbidities compared with those with none, and in a constant event rate over time. Limitations Small sample size. Conclusions Microscopic hematuria and low-grade proteinuria at Henoch-Schonlein purpura diagnosis is a poor prognostic sign for the development of long-term renal impairment. This population should be targeted for prolonged surveillance. |
| Databáze: | OpenAIRE |
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