RESEARCH ARTICLE 24h Urinary Protein Levels and Urine Protein/ Creatinine Ratios Could Probably Forecast

This study aimed to assess the relevance of laboratory tests in Henoch-Schönlein purpura nephritis (HSPN) classification, and determine accurate classification factors. This prospec-tive study included 694 HSPN patients who underwent ultrasound-guided percutaneous renal biopsy (PRB). Renal specimens were scored according to International Study of Kid-ney Disease in Children (ISKDC) classification. Meanwhile, blood samples were immediate-ly collected for laboratory examination. The associations between laboratory parameters and HSPN classification were assessed. Significant differences in levels of serum Th1/Th2 cytokines, immunoglobulins, T-lymphocyte subsets, complement, and coagulation markers were obtained between HSPN patients and healthy children. Interestingly, 24h urinary pro-tein (24h-UPRO) levels and urine protein/urine creatinine ratios could determine HPSN grade IIb, IIIa, and IIIb incidences, with areas under ROC curve of 0.767 and 0.731, respec-tively. At 24h-UPRO>580.35mg/L, prediction sensitivity and specificity were 75.2 % and 70.0%, respectively. These values became 53.0 % and 82.3%, respectively, with 24h-UPRO exceeding 1006.25mg/L. At urine protein/urine creatinine> 0.97, prediction sensitivi-ty and specificity were 65.5 % and 67.2%, respectively, values that became 57.4 % and 80.0%, respectively, at ratios exceeding 1.2. Cell and humoral immunity, coagulation and fi-brinolytic systems are all involved in the pathogenesis of HSPN, and type I hypersensitivity may be the disease trigger of HSPN. 24h-UPRO levels and urine protein/creatinine ratios could probably forecast the pathological classification of HSPN