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Treatment-based literature of Henoch–Schönlein purpura nephritis in childhood

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Abstract

Considerable concern has been expressed on the importance of identifying an improved therapeutic protocol for use in the treatment of childhood Henoch–Schönlein purpura nephritis, primarily due to the unpredictable success shown to date in improving long-term renal outcome. This review focuses on published reports describing the outcomes of therapeutic approaches currently being used in the treatment of pediatric Henoch–Schönlein purpura nephritis, with the aim of providing information that will facilitate a treatment-based approach in children presenting with varying degrees of kidney disease. The conclusions of the authors of this review are that currently prescribed treatments of children affected by Henoch–Schönlein purpura nephritis are not adequately guided by evidence obtained in properly designed, randomized, placebo-controlled trials with outcome markers related to the progression to end stage renal disease (level I evidence). Moreover, firm evidence supporting the best practice to be applied with the aim of delaying the progression of kidney disease is still lacking.

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Abbreviations

ACEI:

angiotensin converting enzyme inhibitor

AZA:

azathioprine

CSA:

cyclosporine A

CYCP:

cyclophosphamide

ESRD:

end stage renal disease

HSP:

Henoch–Schönlein purpura

HSPN:

Henoch–Schönlein purpura nephritis

MM:

mycophenolate mofetil

MP:

methylprednisolone

P-Exch:

plasma exchange

PU:

proteinuria

RCT:

randomized controlled trial

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The authors declare the absence of competing interests.

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Authors and Affiliations

  1. Department of Mother-Child and Biology-Genetics, University of Verona, Piazzale L. Scuro, 10, 37134, Verona, Italy

    Marco Zaffanello

  2. Department of Paediatrics, Neonatal Intensive Care Unit, University of Cagliari, Cagliari, Italy

    Vassilios Fanos

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  1. Marco Zaffanello
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  2. Vassilios Fanos
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Correspondence to Marco Zaffanello.

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Zaffanello, M., Fanos, V. Treatment-based literature of Henoch–Schönlein purpura nephritis in childhood. Pediatr Nephrol 24, 1901–1911 (2009). https://doi.org/10.1007/s00467-008-1066-9

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  • DOI: https://doi.org/10.1007/s00467-008-1066-9

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