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AAP Grand Rounds 14:65 (2005) HSP: Risk of Renal Damage & Follow-Up RecommendationsSource: Narchi H. Risk of long term renal impairment and duration of followup recommended for Henoch-Schönlein purpura (HSP) with normal or minimal urinary findings: a systems review. Arch Dis Child. 2005;90:916920.
Using the Cochrane Library, Medline, and EMBASE, the author analyzed the literature to determine the duration of follow-up needed to assess long-term risk of renal impairment after Henoch-Schönlein purpura (HSP). Of the 34 studies retrieved, only 12 met the criteria for use (previously normal renal function, timed follow-up, presence/absence of renal involvement). The 12 reports were from Europe, the United States, East Asia, the subcontinent of Asia, and the Middle East and included 1,133 children. Across the studies, follow-up ranged from 6 weeks to 36 years. Nearly 66% of the children had normal urinalysis throughout the follow- up period, while 34% had hematuria and/or proteinuria (H/P). Among the children with H/P, 80% had only isolated hematuria or proteinuria, and 20% demonstrated evidence of nephritis (hematuria with 1 or more of the following: elevated serum urea or creatinine, hypertension, or oliguria) or nephrotic syndrome (nephrotic range proteinuria >40µ/m2/hour or 50µ/kg/24 hours
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