What are predictors of nephropathy in Henoch-Schönlein purpura (IgA vasculitis)?

Updated: Oct 28, 2020
  • Author: Rajendra Bhimma, MBChB, MD, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal); Chief Editor: Craig B Langman, MD  more...
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Answer

Predictors of serious nephropathy or ESKD include bloody stools and persistent rash. Initial kidney manifestations and outcomes are as follows [24] :

  • ​Nephrotic and nephritic syndrome - Progression to chronic kidney disease (CKD) in > 50% of cases
  • Nephrotic syndrome - Progression to CKD in ±40% of cases
  • Nephritic syndrome - Progression to CKD in ±15% of cases
  • Heavy non-nephrotic proteinuria - Progression to CKD in ±15% of cases
  • Hematuria and/minimal proteinuria - Progression to CKD in < 5% of cases
  • Nephrotic syndrome persisting for < 3 months - Almost no progression to ESRD
  • Nephrotic syndrome persisting for > 3 months - Progression to ESRD in ±40% of cases.

However, patients with a normal urinalysis at 6 months and without previous renal involvement have not gone on to develop kidney problems. [67]


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