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Treatment of severe Henoch-Schönlein and immunoglobulin A nephritis. A single center experience

Stella Edström Halling1, Magnus P Söderberg, Ulla B Berg

  • 1Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institutet, Karolinska University Hospital, Huddinge, 14186, Stockholm, Sweden. stella.edstrom.halling@ki.se

Pediatric Nephrology (Berlin, Germany)
|October 22, 2008
PubMed

Insights

Two treatment regimens for severe pediatric nephritis showed similar outcomes. Both corticosteroid, cyclophosphamide, and ACEi/ARB therapy, and ACEi/ARB +/- corticosteroids effectively reduced proteinuria and improved kidney function in Henoch-Schönlein nephritis and IgA nephritis.

Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Immunology

Background:

  • Severe Henoch-Schönlein nephritis (HSN) and immunoglobulin A nephritis (IgAN) in children can lead to significant kidney damage.
  • Treatment strategies for severe pediatric nephritis vary, necessitating research into their comparative efficacy.

Purpose of the Study:

  • To compare the effectiveness of two distinct treatment regimens in children with severe HSN and IgAN.
  • To evaluate the impact of treatments on renal function, proteinuria, and histological findings.

Main Methods:

  • A cohort of 43 children with severe HSN (24) and IgAN (19) were analyzed.
  • Group A received corticosteroids, cyclophosphamide (CYC-P), and ACE inhibitors/angiotensin receptor blockers (ACEi/ARB).
  • Group B received ACEi/ARB with or without corticosteroids.

Main Results:

  • Both treatment groups showed decreased proteinuria at follow-up.
  • Group A demonstrated increased GFR and a reduced histopathological activity index.
  • Treatment outcomes were comparable between the two groups and did not differ between HSN and IgAN.

Conclusions:

  • Combined therapy with corticosteroids, CYC-P, and ACEi/ARB is effective in improving renal parameters in severe pediatric nephritis.
  • ACEi/ARB therapy, with or without corticosteroids, also shows benefits in reducing proteinuria.
  • Treatment efficacy did not significantly differ between the two regimens or between HSN and IgAN.

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