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The ISKDC classification and a new semiquantitative classification for predicting outcomes of Henoch–Schönlein purpura nephritis

Background Histological findings from primary kidney biopsies were correlated with patient outcomes in a national cohort of paediatric Henoch–Schönlein nephritis (HSN) patients. Methods Primary kidney biopsies from 53 HSN patients were re-evaluated using the ISKDC (International Study of Kidney Dise... Full description

Journal Title: Pediatric nephrology (Berlin West), 2017, Vol.32 (7), p.1201-1209
Main Author: Koskela, Mikael
Other Authors: Ylinen, Elisa , Ukonmaanaho, Elli-Maija , Autio-Harmainen, Helena , Heikkilä, Päivi , Lohi, Jouko , Jauhola, Outi , Ronkainen, Jaana , Jahnukainen, Timo , Nuutinen, Matti
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0931-041X
Link: https://www.ncbi.nlm.nih.gov/pubmed/28197887
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recordid: cdi_proquest_miscellaneous_1868696649
title: The ISKDC classification and a new semiquantitative classification for predicting outcomes of Henoch–Schönlein purpura nephritis
format: Article
creator:
  • Koskela, Mikael
  • Ylinen, Elisa
  • Ukonmaanaho, Elli-Maija
  • Autio-Harmainen, Helena
  • Heikkilä, Päivi
  • Lohi, Jouko
  • Jauhola, Outi
  • Ronkainen, Jaana
  • Jahnukainen, Timo
  • Nuutinen, Matti
subjects:
  • 3121 Internal medicine
  • 3123 Gynaecology
  • 3126 Surgery
  • Adolescent
  • anesthesiology
  • Biopsy
  • Child
  • Children
  • Classification
  • End-stage renal disease
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Glomerulonephritis
  • Histology
  • Humans
  • intensive care
  • Kidney - pathology
  • Kidney diseases
  • Kidney Failure, Chronic - classification
  • Kidney Failure, Chronic - etiology
  • Kidney Failure, Chronic - pathology
  • Kidney Failure, Chronic - urine
  • Kidney transplantation
  • Male
  • Medicine
  • Medicine & Public Health
  • Nephritis
  • Nephritis - classification
  • Nephritis - etiology
  • Nephritis - pathology
  • Nephritis - urine
  • Nephrology
  • Original Article
  • paediatrics
  • Patients
  • Pediatrics
  • Prognosis
  • Proteinuria - etiology
  • Proteinuria - pathology
  • Proteinuria - urine
  • Purpura, Schoenlein-Henoch - classification
  • Purpura, Schoenlein-Henoch - complications
  • Purpura, Schoenlein-Henoch - pathology
  • Purpura, Schoenlein-Henoch - urine
  • radiology
  • Renal biopsy
  • Renal insufficiency
  • Retrospective Studies
  • ROC Curve
  • Schonlein-Henoch purpura
  • Semiquantitative
  • Urology
  • Vasculitis
ispartof: Pediatric nephrology (Berlin, West), 2017, Vol.32 (7), p.1201-1209
description: Background Histological findings from primary kidney biopsies were correlated with patient outcomes in a national cohort of paediatric Henoch–Schönlein nephritis (HSN) patients. Methods 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. Results 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]. Conclusions Our results suggest that the modified SQC is more sensitive than ISKDC classification for predicting the outcome in HSN cases.
language: eng
source:
identifier: ISSN: 0931-041X
fulltext: no_fulltext
issn:
  • 0931-041X
  • 1432-198X
url: Link


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titleThe ISKDC classification and a new semiquantitative classification for predicting outcomes of Henoch–Schönlein purpura nephritis
creatorKoskela, Mikael ; Ylinen, Elisa ; Ukonmaanaho, Elli-Maija ; Autio-Harmainen, Helena ; Heikkilä, Päivi ; Lohi, Jouko ; Jauhola, Outi ; Ronkainen, Jaana ; Jahnukainen, Timo ; Nuutinen, Matti
creatorcontribKoskela, Mikael ; Ylinen, Elisa ; Ukonmaanaho, Elli-Maija ; Autio-Harmainen, Helena ; Heikkilä, Päivi ; Lohi, Jouko ; Jauhola, Outi ; Ronkainen, Jaana ; Jahnukainen, Timo ; Nuutinen, Matti
descriptionBackground Histological findings from primary kidney biopsies were correlated with patient outcomes in a national cohort of paediatric Henoch–Schönlein nephritis (HSN) patients. Methods 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. Results 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]. Conclusions Our results suggest that the modified SQC is more sensitive than ISKDC classification for predicting the outcome in HSN cases.
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1EISSN: 1432-198X
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subject3121 Internal medicine ; 3123 Gynaecology ; 3126 Surgery ; Adolescent ; anesthesiology ; Biopsy ; Child ; Children ; Classification ; End-stage renal disease ; Feasibility Studies ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Glomerulonephritis ; Histology ; Humans ; intensive care ; Kidney - pathology ; Kidney diseases ; Kidney Failure, Chronic - classification ; Kidney Failure, Chronic - etiology ; Kidney Failure, Chronic - pathology ; Kidney Failure, Chronic - urine ; Kidney transplantation ; Male ; Medicine ; Medicine & Public Health ; Nephritis ; Nephritis - classification ; Nephritis - etiology ; Nephritis - pathology ; Nephritis - urine ; Nephrology ; Original Article ; paediatrics ; Patients ; Pediatrics ; Prognosis ; Proteinuria - etiology ; Proteinuria - pathology ; Proteinuria - urine ; Purpura, Schoenlein-Henoch - classification ; Purpura, Schoenlein-Henoch - complications ; Purpura, Schoenlein-Henoch - pathology ; Purpura, Schoenlein-Henoch - urine ; radiology ; Renal biopsy ; Renal insufficiency ; Retrospective Studies ; ROC Curve ; Schonlein-Henoch purpura ; Semiquantitative ; Urology ; Vasculitis
ispartofPediatric nephrology (Berlin, West), 2017, Vol.32 (7), p.1201-1209
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1Ylinen, Elisa
2Ukonmaanaho, Elli-Maija
3Autio-Harmainen, Helena
4Heikkilä, Päivi
5Lohi, Jouko
6Jauhola, Outi
7Ronkainen, Jaana
8Jahnukainen, Timo
9Nuutinen, Matti
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descriptionBackground Histological findings from primary kidney biopsies were correlated with patient outcomes in a national cohort of paediatric Henoch–Schönlein nephritis (HSN) patients. Methods 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. Results 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]. Conclusions Our results suggest that the modified SQC is more sensitive than ISKDC classification for predicting the outcome in HSN cases.
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18Kidney - pathology
19Kidney diseases
20Kidney Failure, Chronic - classification
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23Kidney Failure, Chronic - urine
24Kidney transplantation
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27Medicine & Public Health
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32Nephritis - urine
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38Prognosis
39Proteinuria - etiology
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46radiology
47Renal biopsy
48Renal insufficiency
49Retrospective Studies
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titleThe ISKDC classification and a new semiquantitative classification for predicting outcomes of Henoch–Schönlein purpura nephritis
authorKoskela, Mikael ; Ylinen, Elisa ; Ukonmaanaho, Elli-Maija ; Autio-Harmainen, Helena ; Heikkilä, Päivi ; Lohi, Jouko ; Jauhola, Outi ; Ronkainen, Jaana ; Jahnukainen, Timo ; Nuutinen, Matti
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13123 Gynaecology
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3Adolescent
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6Child
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8Classification
9End-stage renal disease
10Feasibility Studies
11Female
12Follow-Up Studies
13Glomerular Filtration Rate
14Glomerulonephritis
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16Humans
17intensive care
18Kidney - pathology
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20Kidney Failure, Chronic - classification
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48Renal insufficiency
49Retrospective Studies
50ROC Curve
51Schonlein-Henoch purpura
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53Urology
54Vasculitis
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abstractBackground Histological findings from primary kidney biopsies were correlated with patient outcomes in a national cohort of paediatric Henoch–Schönlein nephritis (HSN) patients. Methods 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. Results 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]. Conclusions Our results suggest that the modified SQC is more sensitive than ISKDC classification for predicting the outcome in HSN cases.
copBerlin/Heidelberg
pubSpringer Berlin Heidelberg
pmid28197887
doi10.1007/s00467-017-3608-5
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