Efficacy of triptolide for children with moderately severe Henoch-Schönlein purpura nephritis presenting with nephrotic range proteinuria: a prospective and controlled study in China.
OBJECTIVE
To observe the clinical efficacy of the Chinese herb, Triptolide, in children with moderately severe Henoch-Schönlein purpura nephritis (HSPN).


METHODS
From January 2007 to December 2011, 56 HSPN children manifested by nephrotic range proteinuria with normal kidney function and <50% crescents or sclerosing lesions on biopsy were hospitalized in the Children's Hospital of Zhejiang University School of Medicine. They were divided into two groups: the treatment group (n = 42; Triptolide at a dosage of 1 mg/kg · d, combined with prednisone at a dosage of 2 mg/kg · d, within a course of medium-to-long-term therapy of 6 to 9 months) and the control group (n = 14; prednisone alone, with the same procedure).


RESULTS
Short-term remission was observed in 95% of patients from treatment group and in 72% of patients from control group, respectively. There was a significant difference between both groups (χ(2) = 6.222, P = 0.029) for short-term effects. Meanwhile, no significant difference, as proteinuria, hematuria, hypertension, and decreased eGFR, was observed between the two groups in long-term followup (χ(2) = 3.111, P = 0.097). The Kaplan-Meier plot analysis also revealed no significant difference (χ(2) = 2.633, P = 0.105).


CONCLUSIONS
Triptolide is effective in relieving short-term symptoms for moderately severe HSPN children, though its long-term effects need to be observed further.
Department of Nephrology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China ; Department of Pediatrics, The Second People's Hospital of Linhai, Linhai, Zhejiang 317016, China.
Li
L
Wu
Department of Nephrology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
Jianhua
J
Mao
Department of Nephrology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
Xia
X
Jin
Department of Nephrology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
Haidong
H
Fu
Department of Nephrology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
Huijun
H
Shen
Department of Nephrology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
Jingjing
J
Wang
Department of Nephrology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
Aimin
A
Liu
Department of Nephrology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
Qiang
Q
Shu
Department of Nephrology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
Lizhong
L
Du
D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D002681:China; D004224:Diterpenes / Q000008:administration & dosage*; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D004852:Epoxy Compounds / Q000008:administration & dosage; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000188:drug therapy* / Q000473:pathology; D053208:Kaplan-Meier Estimate; D008297:Male; D009393:Nephritis / Q000188:drug therapy* / Q000473:pathology; D010616:Phenanthrenes / Q000008:administration & dosage*; D011507:Proteinuria / Q000188:drug therapy / Q000473:pathology
D004224:Diterpenes; D004365:Drugs, Chinese Herbal; D004852:Epoxy Compounds; D010616:Phenanthrenes; C001899:triptolide