Analysis of clinical pathological features and prognoses of children with Henoch-Schönlein purpura nephritis with hypertension

Objective To explore the clinicopathological features and prognoses of children with Henoch-Schönlein purpura nephritis(HSPN)with hypertension.Methods From January 2015 to December 2019,clinicopathological data of 148 HSPN children were retrospectively analyzed.According to whether or not there was a complication of hypertension,they were divided into the groups of HSPN with normal blood pressure(n=105,70.9%)and HSPN with hypertension(n=43,29.1%).The clinicopathological features and prognoses of two groups were compared.Results No significant inter-group difference existed in gender,age or onset time.The incidence of nocturnal hypertension was significantly higher than that of daytime hypertension in hypertension group(χ²=9.446,P<0.01).And the incidence of abnormal blood pressure(non-dipper BP & reversed dipper BP patterns)was 79.1% and 77.1% in two groups respectively and the difference was statistically insignificant.Compared with normal blood pressure group,24-hour urinary protein quantity,degree of urinary microalbumin,serum creatinine and total cholesterol in hypertension group were more severe than those in normal blood pressure group and the difference was statistically significant(P<0.05).However,no significant difference existed in blood complement C3,serum albumin or platelet count.Nephrotic syndrome was a predominant clinical type in hypertension group and it was more severe than that in normal blood pressure group.And the difference was statistically significant(χ²=35.470,P<0.01).The pathological classification of hypertension group was type Ⅲ and above and it was more severe than that of normal blood pressure group.And the difference was statistically significant(χ²=25.642,P<0.01).As compared with normal blood pressure group,the prognosis of hypertension group was worse and the difference was statistically significant(χ²=6.663,P<0.05).Conclusions HSPN children with hypertension is mostly characterized by elevated blood pressure at nighttime.The clinicopathological types are more severe than those with normal blood pressure in HSPN and the prognosis of kidney is worse.For HSPN children with hypertension,physicians should focus upon managing blood pressure and improving the prognosis of children.