Pediatrics Medical News about kidney disease; Henoch-Schonlein Purpura

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Interventions for preventing and treating kidney disease in Henoch-Schonlein Purpura (HSP)
Cochrane Reviews, 07/09/09

Chartapisak W et al. - This review identified five studies (789 children) which compared prednisone tablets given for 14-28 days with placebo tablets or no specific treatment for the prevention of serious kidney disease at 6-12 months after onset of HSP. No significant reduction in the frequency of serious kidney disease was demonstrated. Two studies (138 children) showed no benefit of aspirin and dipyridamole (antiplatelet agents) to prevent serious kidney disease. One study (228 children) suggested that heparin given by injection could reduce the risk for serious kidney disease but this treatment has the potential side effect of severe bleeding so its administration is not justified when only one third of children develop kidney disease and in most this is not serious and resolves completely. In children with serious kidney disease, one study (56 children) showed that cyclophosphamide was no more effective than supportive treatment in preventing kidney failure. A second study (19 children) found no difference in benefit between cyclosporin and methylprednisolone/prednisone but numbers were too small to exclude a benefit completely.

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