Improved outcome of Henoch-Schonlein purpura nephritis by early intensive treatment

Abstract

Objective: To evaluate the different therapies used to treat mild, moderate and severe Henoch-Schonlein purpura nephritis (HSPN) patients and to identify the most effective treatment.

Methods: One hundred and eighty six children were evaluated retrospectively. They were divided into mild, moderate and severe condition groups. Different therapeutic protocols of non-steroid therapy, hydrocortisone sodium succinate (HCSS) therapy, methylprednisolone (MP) pulse therapy, and MP in combination with tripterygium glycoside (TG) therapy were used to treat the different groups.

Results: After 4 wk, in the mild group, patients were more likely to respond to HCSS therapy than non-steroid therapy (P < 0.05). Moderate HSPN patients were more likely to respond to MP therapy than HCSS therapy (P < 0.05). Severe HSPN patients were more likely to respond to MP in combination with TG than single MP therapy (P < 0.05). At last follow-up, all children had normal urinalysis, blood pressure and serum urea and creatinine. In the mild group, the mean duration of proteinuria was shorter in HCSS therapy group than in non-steroid therapy group (P < 0.05). In the moderate group, the mean duration of proteinuria was shorter in MP pulse therapy group than in HCSS therapy group (P < 0.05).

Conclusions: The present study has demonstrated a superior effect of HCSS therapy in patients with mild HSPN disease, of MP therapy in patients with moderate disease, and of MP in combination with TG therapy in patients with severe disease. Intensive therapy administered initially reduces the duration of urinary protein abnormality.