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Early weight gain and outcome in Henoch-Schönlein nephritis
C Plank1, I Vasilache, K Dittrich
1Department of Pediatrics, University Hospital Erlangen, Germany.
Insights
Low birth weight and early weight gain in infancy do not appear to worsen the course of Henoch-Schönlein Purpura nephritis in children. However, rapid early weight gain was linked to higher blood pressure at diagnosis.
Area of Science:
- Pediatric Nephrology
- Growth and Development
Background:
- Intrauterine growth restriction may predispose children to severe secondary kidney diseases.
- Catch-up growth post-birth is a critical factor in managing these conditions.
Purpose of the Study:
- To investigate the association between low birth weight or early infant weight gain and the severity of nephritis in Henoch-Schönlein Purpura (PSHN).
Main Methods:
- Retrospective analysis of 34 children diagnosed with PSHN.
- Patients categorized by birth weight standard deviation score (SDS) tertiles.
- Early weight gain defined as SDS gain >0.67 between birth and 2 years.
Main Results:
- No significant association found between low birth weight and the long-term course of PSHN.
- Children with rapid early weight gain (SDS gain >0.67) showed a higher incidence of arterial hypertension at PSHN diagnosis (p=0.01).
- Higher median systolic blood pressure SDS was observed in the high weight gain group (p=0.008).
Conclusions:
- This study does not support a link between low birth weight or early weight gain and the later course of PSHN in children.
- Early rapid weight gain is associated with elevated systolic blood pressure during the initial PSHN presentation.
Background:
Intrauterine growth restriction seems to be a risk factor for an aggravated course of secondary renal diseases in children. Catch-up growth after birth may play a critical role. We tested if there is an association between an aggravated course of nephritis in Henoch-Schönlein Purpura (PSHN) and low birth weight or early weight gain during infancy.
Patients:
We retrospectively analysed the clinical course of 34 children with PSHN.
Methods:
Patients were sorted according their birth weight standard deviation score (SDS) in tertiles. Early weight gain was defined as gain of weight standard deviation score >0.67 between birth and 2 years of age.
Results:
Patients with higher birth weight needed Cyclophosphamide in a higher rate than low birth weight children. In the high weight gain group (SDS gain >0.67) 9 of the 11 patients compared to 7 of 22 patients in the low weight gain group (SDS gain <0.67) presented with arterial hypertension during the initial manifestation of PSH nephritis (p=0.01). Median systolic blood pressure SDS in the high weight gain group was 1.54 (-1.39-4.71) versus 0.29 (0.52-4.05) in the low weight gain group (p=0.008). Nevertheless, other clinical parameters during first manifestation and follow-up were not relevantly different.
Conclusion:
In contrast to the data of children with idiopathic nephrotic syndrome or IgA nephropathy, this study does neither provide evidence for an association between low birth weight nor early weight gain and the later course of PSHN. Interestingly, early weight gain was associated with a higher systolic blood pressure during the initial manifestation of PSHN.
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