ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on Twitter

Kidney Week

Abstract: SA-PO443

Long-Term Outcome of 62 Pediatric Henoch-Schönlein Nephritis Patients Treated with Methylprednisolone Pulses or Cyclosporine A

Session Information

  • Pediatric Nephrology - II
    October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1600 Pediatric Nephrology


  • Koskela, Antti, University of Helsinki and Helsinki University Hospital, Finland, Helsinki, Finland
  • Jahnukainen, Timo, Children?s Hospital, Helsinki University Hospital, Helsinki, Finland
  • Endén, Kira, Tampere University hospital, Tampere, Finland
  • Arikoski, Pekka Matti, Kuopio University Hospital, Kuopio, Finland
  • Kataja, Janne T., Turku University Hospital , Turku, Finland
  • Nuutinen, Matti, Oulu University Hospital, Oulu, Finland
  • Ylinen, Elisa, Children''s Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, Finland

The optimal treatment of Henoch-Schönlein purpura nephritis (HSN) has remained unclear. We evaluated the outcome of pediatric HSN patients treated initially with methylprednisolone (MP) or cyclosporine A (CyA) in the five university hospitals in Finland between 1996 and 2011.


The medical charts were reviewed until the last follow-up visit and 47 (76 %) patients attended also additional urine and blood sample screening. MP-treated patients (n=42) received three 30 mg/kg pulses followed by oral prednisone for a median of 4.3 (IQR 3.8 – 5.9) months. Median treatment time for CyA-treated patients (n=20) was 1.2 (IQR 1.0 – 1.7) years with an initial target blood concentration of 150-200 µmol/l. Fifty-nine (95 %) patients had received ACE-Is and/or ARBs.


Baseline characteristics at the time of renal biopsy and outcome after a mean follow-up of 10.8 years are shown in Table 1. Eighteen (90 %) CyA-treated and 26 (62 %) MP-treated patients achieved favorable treatment response with initial treatment and needed no additional immunosuppressive therapy (RR 1.45, 95 % CI 1.07 – 1.96, p=0.035; for favorable treatment response). One patient developed ESRD and another patient had decreased renal function (eGFR <60 ml/min/1.73m2), both initially treated with MP. Six patients (5 MP, 1 CyA) had mildly decreased renal function (eGFR 60 – 89 ml/min/1.73m2), one of them having non-nephrotic proteinuria.


Renal outcome was good in both treatment groups. However, CyA-treated patients needed less additional immunosuppressive treatment and none of the initially CyA-treated patients had decreased renal function (eGFR <60 ml/min/1.73m2) after 10.8 years of follow-up. Urinary abnormalities may persist or develop and therefore long-term follow-up of HSN patients is mandatory.

Table 1
Baseline characteristics at renal biopsyInitial MP treatment (n=42)Initial CyA Treatment (n=20)p-value
Age (years)9.5 ± 3.310.7 ± 3.40.16
Patients with nephrotic-range proteinuria (>40mg/m2/h)36 (86 %)14 (74 %)0.29
ISKDC grade ≥ III (%)29 (71 %)18 (90 %)0.12
Outcome at the end of follow-up   
Patients with proteinuria (%)9 (22 %)2 (11 %)0.48
Patients with hematuria (%)5 (13 %)3 (17 %)0.70
Patients with blood pressure medication (%)8 (20 %)7 (35 %)0.22
eGFR (ml/min/1.73m2)110 ± 21109 ± 120.95


  • Private Foundation Support