Background/Aims: Renal involvement comprises one of the major organ involvements in childhood vasculitis and has also an important role in the long term prognosis. The aim of this retrospective study was to analyze the demographic, clinical, laboratory features, and the treatment modalities of patients with vasculitis who had renal involvement. Methods: Patients with the diagnosis of vasculitis who had been followed in two pediatric nephrology centers between 1990 and 2005 were analyzed retrospectively.Patients with renal involvement were selected and further evaluated. Results: The study population consisted of 152 of 816 patients with vasculitis. Renal involvement was seen in 134 patients (17%) with Henoch-Schönlein purpura(HSP), 14 patients (45%) with polyarteritis nodosa(PAN), 3 patients with Takayasu arteritis (TA) (50%) and in 1 Wegener granulomatosis (WG) patient.Themean age of patients with renal involvement was 9.2 ± 0.91 years in the HSP group. Hematuria with proteinuria was the most common renal finding and joint manifestations were seen less in this group. During the follow-up, only 1 patient developed chronic renal failure. Proteinuria, hematuria and aneurysms were seen in 26, 35 and 57% respectively in the PAN group. Only 1 patient (3.2%) had developed chronic renal failure.All 3 patients with TA had bilateral renal arterial involvement. Conclusion: Renal involvement constitutes an important part of childhood vasculitides. With the institution of early and aggressive immunosuppressive treatment significant improvement in the long-term survival of these patients can be achieved.

Keywords:
Henoch-Schönlein purpura, Polyarteritis nodosa, Takayasu arteritis, Vasculitis
1.
Arend WP, Michel BA, Bloch DA, et al: The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 1990;33:1129–1134.
2.
Cassidy JT, Petty RE: Vasculitis and its classification; in Cassidy JT, Petty RE, Laxer RM, Lindsley CB (eds): Textbook of Pediatric Rheumatology. Philadelphia, Elsevier Saunders, 2005, pp 492–496.
3.
Cassidy JT, Petty RE: Leucocytoclastic vasculitis; in Cassidy JT, Petty RE, Laxer RM, Lindsley CB (eds): Textbook of Pediatric Rheumatology. Philadelphia, Elsevier Saunders, 2005, pp 496–512.
4.
Cassidy JT, Petty RE: Polyarteritis nodosa and related vasculitides; in Cassidy JT, Petty RE, Laxer RM, Lindsley CB (eds). Textbook of Pediatric Rheumatology. Philadelphia, Elsevier Saunders, 2005, pp 512–521.
5.
Chang WL, Yang YH, Wang LC, Lin YT, Chiang BL: Renal manifestations in Henoch-Schönlein purpura: a 10 year clinical study. Pediatr Nephrol 2005;20:1269–1272.
6.
Counahan R, Winterborn MH, White RH, Heaton JM, Meadow SR, Bluett NH, et al: Prognosis of Henoch-Schönlein nephritis in children. BR Med J1977;ii:11–14.
7.
Fink CW: Polyarteritis and other disease with necrotizing vasculitis in childhood. Arthritis Rheum 1977;20:378–384.
8.
Jain S, Sharma B, Singh S, Bali HK, Kumar L, Sharma BK: Takayasu arteritis in children and young Indians. Int J Cardiol 2000;75(suppl 1):153–157.
9.
Leavitt RY, Fauci AS, Bloch DA, Michel BA, Hunder GG, Arend WP, et al: The American College of Rheumatology 1990 criteria for the classification of Wegener’s granulomatosis. Arthritis Rheum 1990;33:1101–1107.
10.
Lightfoot RW Jr, Michel BA, Bloch DA, Hunder GG, Zvaifler NJ, Mc Shane DJ, et al: The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum 1990;33:1088–1093.
11.
Merkel PA, Lo GH, Holbrook JT, Tibbs AK, Allen NB, Davis JC Jr, et al: Brief communication: high incidence of venous thrombotic events among patients with Wegener granulomatosis: the Wegener’s Clinical Occurrence of Thrombosis (WeCLOT) Study. Ann Intern Med 2005;142:620–626.
12.
Mills JA, Michel BA, Bloch DA, Calabrese LH, Hunder GG, Arend WP, et al: The American College of Rheumatology 1990 criteria for the classification of Henoch-Schönlein purpura. Arthritis Rheum 1990;33:1114–1121.
13.
Mir S, Yavaşcan Ö, Mutlubaş F, Yeniay B, Sönmez F: Clinical outcome in children with Henoch-Schönlein nephritis. Pediatr Nephrol 2007;22:64–70.
14.
Özen S, Bakkaloğlu A, Düşünsel R, Söylemezoğlu, Özaltın F, Poyrazoğlu H, et al: Childhood vasculitis in Turkey: a nationwide survey. Clin Rheumatol 2007;26:196–200.
15.
Özen S, Anton J, Arısoy N, Bakkaloğlu A, Beşbaş N, Brogan P, et al: Juvenile polyarteritis: results of a multicenter survey of 110 children. J Pediatr 2004;145:517–522.
16.
Shin JI, Park JM, Shin YH, Hwang DH, Kim JH, Lee JS: Predictive factors for nephritis, relapse, and significant proteinuria in childhood Henoch-Schönlein purpura. Scand J Rheumatol 2006;35:56–60.
17.
Sundel R, Szer I: Vasculitis in childhood. Rheum Dis Clin N Am2002;28:625–654.
18.
Trapani S, Micheli A, Grisolia F, Resti M, Chiappini E, Falcini F, et al: Henoch Schonlein Purpura in childhood: Epidemiological and clinical analysis of 150 cases over a 5-year period and review of literature. Semin Arthritis Rheum 2005;35:143–153.
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2008
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