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. 2020 Nov 2;20(1):501.
doi: 10.1186/s12887-020-02404-2.

Risk factors associated with renal crescentic formation in pediatric Henoch-Schönlein purpura nephritis: a retrospective cohort study

Yong-Rui Song  1 , Wan-Liang Guo  1 , Mao Sheng  1 , Qiang Lin  2 , Xue-Ming Zhu  3 , Xiao-Zhong Li  4
Affiliations

Risk factors associated with renal crescentic formation in pediatric Henoch-Schönlein purpura nephritis: a retrospective cohort study

Yong-Rui Song et al. BMC Pediatr. .

Abstract

Background: The long-term prognosis of Henoch-Schönlein purpura (HSP) depends on the severity of renal involvement, and crescent formation is considered an important risk factor for poor prognosis of Henoch-Schönlein purpura nephritis (HSPN). The objective of this study was to evaluate factors affecting crescent formation in children with HSPN.

Methods: Demographic factors, clinical characteristics, and laboratory data of children with HSPN with or without crescents were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to determine the risk factors of crescent formation in HSPN.

Results: A total of 191 children with HSPN were enrolled in the study. There were 107 (56%) males and 84 (44%) females, with a median age of 7 years (range: 2 years-15 years). International Study of Kidney Disease in Children (ISKDC) grading was used to divide subjects into two groups: those without glomerular crescent formation (ISKDC grades I-II, n = 146 cases) and those with glomerular crescent formation (ISKDC grades III-V, n = 45 cases). Logistic regression analysis showed that higher urinary white blood cell (WBC) count (OR = 3.300; 95% CI, 1.119-9.739; P = 0.0306) and higher urinary microalbumin/creatinine ratio (ACR) (OR = 25.053; 95% CI, 1.354-463.708; P = 0.0305) were independent risk factors for the formation of crescents in HSPN. The area under the receiver operating characteristic curve of urinary WBC and ACR were 0.753 and 0.698 respectively, with the Hosmer and Lemeshow goodness-of-fit test (P = 0.0669, P > 0.05).

Conclusion: These results suggest that higher urinary WBC count and ACR should be strictly monitored for children with HSPN. Adequate clinical intervention for these risk factors may limit or prevent renal crescent formation.

Keywords: Crescent formation; HSPN; Henoch-Schönlein purpura nephritis; Risk factors.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
ROC curve to evaluate the diagnostic efficiency of the model. Area under the curve = 0.753 and 0.698, respectively
See this image and copyright information in PMC

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