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• W2953417642 abstract "Henoch-Schönlein purpura nephritis (HSPN) is a common secondary glomerulonephritis, which can cause end-stage renal disease (ESRD) or death. Owing to a relatively lower incidence of adolescent and adult patients, the clinicopathological features and the pathophysiological process of HSPN are not fully elucidated. Bilirubin, a degradation product of heme, has been identified as an endogenous antioxidant and cellular protectant, with potent abilities of complement inhibitory and anti-inflammatory. However, correlation between serum bilirubin level and progression of HSPN is not still illuminated. Therefore, the present study was conducted to evaluate whether serum bilirubin levels could serve as an independent predictor of HSPN and clarify the potential influence of serum bilirubin on development of HSPN. This study prospectively analyzed 189 HSPN patients over 14 years old. The patients were divided into two groups by ROC curve and the optimum cut-off value of total serum bilirubin was 6.35 umol/L. A total of 147 patients were assigned to the high serum bilirubin (HsB) group while 42 patients were categorized into the low serum bilirubin (LsB) group. The composite endpoints were defined as a 50% decline in eGFR, ESRD and/or death. A Kaplan-Meier (K-M) analysis and a multivariate Cox analysis were carried out to determine the predictors for renal outcomes. In order to eliminate the influence of different baseline data, a 1:2 propensity score (PS) match based on the greedy matching algorithm was performed to make the results comparable and convictive. Thirteen patients reached the renal endpoints during the mean 27.3 months follow-up. The bilirubin levels of the vast majority of HSPN patients in our cohort were within normal range and total serum bilirubin was positively correlated to direct bilirubin and indirect serum bilirubin. The baseline data suggested that patients in LsB group had significantly higher levels of systolic blood pressure, proteinuria, serum creatine and crescent formation and lower levels of albumin. In the K-M analysis, high levels of serum bilirubin were significantly correlated with a better prognosis (3.4% vs 19.0%; P=0.001) and the multivariate Cox analysis indicated that serum bilirubin was an independent protective factor for renal survival (HR, 0.201; 95% CI, 0.042-0.969; P=0.046). After 1:2 PS matching (LsB group, n=34; HsB group, n=52), the baseline conditions between the two groups had no statistical differences. Similar outcomes were demonstrated in K-M curve (5.8% vs 20.6%; P=0.025) and the multivariate Cox analysis (HR, 0.128; 95% CI, 0.019-0.873; P=0.036). Elevated bilirubin levels are markedly related to the favorable renal outcomes and bilirubin concentrations could serve as an independent risk factor of HSPN. Further studies are required to clarify whether HSPN patients could get benefit from administration of bilirubin." @default.
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• W2953417642 date "2019-07-01" @default.
• W2953417642 modified "2023-09-26" @default.
• W2953417642 title "MON-012 PROGNOSTIC IMPACT OF SERUM TOTAL BILIRUBIN ON RENAL OUTCOME IN HENOCH-SCHONLEIN PURPURA NEPHRITIS" @default.
• W2953417642 doi "https://doi.org/10.1016/j.ekir.2019.05.768" @default.
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