title: 24h Urinary Protein Levels and Urine Protein/Creatinine Ratios Could Probably Forecast the Pathological Classification of HSPN.
abstract: This study aimed to assess the relevance of laboratory tests in Henoch-Schönlein purpura nephritis (HSPN) classification, and determine accurate classification factors. This prospective study included 694 HSPN patients who underwent ultrasound-guided percutaneous renal biopsy (PRB). Renal specimens were scored according to International Study of Kidney Disease in Children (ISKDC) classification. Meanwhile, blood samples were immediately collected for laboratory examination. The associations between laboratory parameters and HSPN classification were assessed. Significant differences in levels of serum Th1/Th2 cytokines, immunoglobulins, T-lymphocyte subsets, complement, and coagulation markers were obtained between HSPN patients and healthy children. Interestingly, 24h urinary protein (24h-UPRO) levels and urine protein/urine creatinine ratios could determine HPSN grade IIb, IIIa, and IIIb incidences, with areas under ROC curve of 0.767 and 0.731, respectively. At 24h-UPRO >580.35mg/L, prediction sensitivity and specificity were 75.2% and 70.0%, respectively. These values became 53.0% and 82.3%, respectively, with 24h-UPRO exceeding 1006.25mg/L. At urine protein/urine creatinine > 0.97, prediction sensitivity and specificity were 65.5% and 67.2%, respectively, values that became 57.4% and 80.0%, respectively, at ratios exceeding 1.2. Cell and humoral immunity, coagulation and fibrinolytic systems are all involved in the pathogenesis of HSPN, and type I hypersensitivity may be the disease trigger of HSPN. 24h-UPRO levels and urine protein/creatinine ratios could probably forecast the pathological classification of HSPN.
authors.affiliation: The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, PR China; Zhejiang Key Laboratory for Diagnosis and Treatment of Neonatal Diseases, Hangzhou, PR China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Ye
authors.affiliation: The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, PR China.
authors.forename: Shi-Qiang
authors.initials: SQ
authors.lastname: Shang
authors.affiliation: The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, PR China.
authors.forename: Ai-Min
authors.initials: AM
authors.lastname: Liu
authors.affiliation: Zhejiang Chinese Medical University, Hangzhou, PR China.
authors.forename: Ting
authors.initials: T
authors.lastname: Zhang
authors.affiliation: The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, PR China.
authors.forename: Hong-Qiang
authors.initials: HQ
authors.lastname: Shen
authors.affiliation: The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, PR China.
authors.forename: Xue-Jun
authors.initials: XJ
authors.lastname: Chen
authors.affiliation: The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, PR China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Mao
mesh_terms: D000293:Adolescent; D000906:Antibodies / Q000097:blood / Q000276:immunology; D015415:Biomarkers; D001706:Biopsy; D002097:C-Reactive Protein; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003165:Complement System Proteins / Q000276:immunology; D003404:Creatinine / Q000652:urine*; D016207:Cytokines / Q000097:blood; D004909:Erythrocyte Indices; D005260:Female; D006456:Hemoglobinuria / Q000209:etiology; D006801:Humans; D011695:IgA Vasculitis / Q000097:blood / Q000150:complications* / Q000276:immunology / Q000652:urine*; D008297:Male; D009393:Nephritis / Q000175:diagnosis* / Q000209:etiology*; D011379:Prognosis; D011446:Prospective Studies; D011507:Proteinuria / Q000209:etiology*; D012372:ROC Curve; D012720:Severity of Illness Index; D016176:T-Lymphocyte Subsets / Q000276:immunology / Q000378:metabolism
chemical_list: D000906:Antibodies; D015415:Biomarkers; D016207:Cytokines; D003165:Complement System Proteins; D002097:C-Reactive Protein; D003404:Creatinine