Clinical outcomes, when matched at presentation, do not vary between adult-onset Henöch-Schönlein purpura nephritis and IgA nephropathy.
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.
Divison of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Hyung Jung
HJ
Oh
Song Vogue
SV
Ahn
Dong Eun
DE
Yoo
Seung Jun
SJ
Kim
Dong Ho
DH
Shin
Mi Jung
MJ
Lee
Hyoung Rae
HR
Kim
Jung Tak
JT
Park
Tae-Hyun
TH
Yoo
Shin-Wook
SW
Kang
Kyu Hun
KH
Choi
Seung Hyeok
SH
Han
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications*; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000473:pathology / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009393:Nephritis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D057216:Propensity Score; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
D015415:Biomarkers; D003404:Creatinine