The ISKDC classification and a new semiquantitative classification for predicting outcomes of Henoch-Schonlein purpura nephritis

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Koskela , M , Ylinen , E , Ukonmaanaho , E-M , Autio-Harmainen , H , Heikkilä , P , Lohi , J , Jauhola , O , Ronkainen , J , Jahnukainen , T & Nuutinen , M 2017 , ' The ISKDC classification and a new semiquantitative classification for predicting outcomes of Henoch-Schonlein purpura nephritis ' , Pediatric Nephrology , vol. 32 , no. 7 , pp. 1201-1209 . https://doi.org/10.1007/s00467-017-3608-5

Title: The ISKDC classification and a new semiquantitative classification for predicting outcomes of Henoch-Schonlein purpura nephritis
Author: Koskela, Mikael; Ylinen, Elisa; Ukonmaanaho, Elli-Maija; Autio-Harmainen, Helena; Heikkilä, Päivi; Lohi, Jouko; Jauhola, Outi; Ronkainen, Jaana; Jahnukainen, Timo; Nuutinen, Matti
Contributor: University of Helsinki, Children's Hospital
University of Helsinki, Clinicum
University of Helsinki, Department of Pathology
University of Helsinki, Medicum
University of Helsinki, HUS Children and Adolescents
Date: 2017-07
Language: eng
Number of pages: 9
Belongs to series: Pediatric Nephrology
ISSN: 0931-041X
URI: http://hdl.handle.net/10138/237008
Abstract: Histological findings from primary kidney biopsies were correlated with patient outcomes in a national cohort of paediatric Henoch-Schonlein nephritis (HSN) patients. Primary kidney biopsies from 53 HSN patients were re-evaluated using the ISKDC (International Study of Kidney Disease in Children) classification and a modified semiquantitative classification (SQC) that scores renal findings and also takes into account activity, chronicity and tubulointerstitial indices. The ISKDC and SQC classifications were evaluated comparatively in four outcome groups: no signs of renal disease (outcome A, n = 27), minor urinary abnormalities (outcome B, n = 18), active renal disease (outcome C, n = 3) and renal insufficiency, end-stage renal disease or succumbed due to HSN (outcome D, n = 5). For the receiver operating characteristic and logistic regression analyses, outcomes A and B were considered to be favourable and outcomes C and D to be unfavourable. The median follow-up time was 7.3 years. The patients with an unfavourable outcome (C and D), considered together due to low patient numbers, had significantly higher total biopsy SQC scores and activity indices than those who had a favourable one (groups A and B). The chronicity and tubulointerstitial indices differed significantly only between group C + D and group A. The difference in areas under the curve between the total biopsy SQC scores and ISKDC findings was 0.15 [p = 0.04, normal-based 95% confidence interval (CI) 0.007-0.29, bias-controlled 95% CI -0.004 to 0.28]. Our results suggest that the modified SQC is more sensitive than ISKDC classification for predicting the outcome in HSN cases.
Subject: Children
Glomerulonephritis
Histology
Renal biopsy
Semiquantitative
Vasculitis
IGA NEPHROPATHY
OXFORD CLASSIFICATION
RETROSPECTIVE COHORT
SCHOENLEIN NEPHRITIS
PULSE THERAPY
FOLLOW-UP
CHILDREN
ADULTS
METHYLPREDNISOLONE
PREDNISONE
3123 Gynaecology and paediatrics
3126 Surgery, anesthesiology, intensive care, radiology
3121 General medicine, internal medicine and other clinical medicine
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