Obesity is associated with Henoch-Schönlein Purpura Nephritis and development of end-stage renal disease in children

Objectives: To explore the association of obesity with the occurrence of Henoch-Schönlein Purpura Nephritis (HSPN) and development of end-stage renal disease (ESRD) in children with Henoch-Schönlein Purpura (HSP). Methods: This was a retrospective study of 446 pediatric patients with diagnosed HSP. All patients’ demographic characteristics, clinical features, and laboratory data were collected from the electronic medical records in hospitals from January 2008 to December 2014, and the prognosis was followed up till December 2018. Multivariate logistic regression and the Cox proportional hazard regression were employed for exploring the potential risk factors for occurrence of HSPN and development of ESRD, respectively. Results: It is reported that 35.2% (n = 157) of HSP patients had HSPN. The multivariate logistic regression showed that obesity (OR = 3.82; 95% CI: 1.92–7.49; p < .01), age over 6 years old at onset (OR = 2.24; 95% CI: 1.32–4.87; p < .01) and angioedema (OR = 1.72; 95% CI: 1.25–4.02; p < .01) were significantly associated with the occurrence of HSPN. During a median follow-up of 52.0 months, 5.2% (n = 23) of HSP patients developed ESRD. The Cox proportional hazard regression indicated that obesity (HR = 3.27; 95% CI: 2.01–6.37; p < .01) and International Study of Kidney Disease of Children (ISKDC) III (HR= 2.88; 95% CI: 1.96–3.80; p < .01) were predictors for the development of ESRD in patients with HSP. Conclusions: Obesity is associated with an increased risk of renal involvement and contributes to the development of ESRD in pediatric patients with HSP.