Pathological characteristics, therapeutic strategies, and prognostic assessment in children with crescentic IgA vasculitis with nephritis

Qiu-Shuang ZHANG; Xiao-Qing YANG; Xiao-Feng MEI; Jin-Gang LI; Meng-Ke BAI

doi:10.7499/j.issn.1008-8830.2605065

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Chinese Journal of Contemporary Pediatrics ›› 2026, Vol. 28 ›› Issue (9) : 1086-1092. DOI: 10.7499/j.issn.1008-8830.2605065

CLINICAL RESEARCH

Pathological characteristics, therapeutic strategies, and prognostic assessment in children with crescentic IgA vasculitis with nephritis

Qiu-Shuang ZHANG ¹^,² ,
Xiao-Qing YANG ¹^,² ,
Xiao-Feng MEI ¹^,² ,
Jin-Gang LI ¹^,² ,
Meng-Ke BAI ¹^,²

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Abstract

Objective To analyze the associations between crescent proportion and renal pathology, laboratory indicators, and prognosis in children with IgA vasculitis with nephritis (IgAVN), and to assess the impact of different treatment strategies on urinary protein and prognosis. Methods A total of 329 children with IgAVN and crescent formation were stratified by crescent proportion into a crescent <25% group and a crescent ≥25% group. Relationships of crescent proportion and treatment strategies with pathological features, laboratory testing results and outcomes were evaluated. Results Compared with the crescent <25% group, the crescent ≥25% group showed higher urine occult blood, urine protein, urinary N-acetyl-β-D-glucosaminidase, and serum urea levels, with decreased renal function and higher acute tubulointerstitial injury scores (P<0.05). Steroids combined with tripterygium glycosides, mycophenolate mofetil or Kunxian capsule all reduced the urine protein/creatinine ratio (P<0.001). The steroid plus Kunxian capsule regimen was associated with the best prognosis (P<0.05). Conclusions A higher crescent proportion is associated with more severe renal injury in pediatric IgAVN. Steroids combined with Kunxian capsule improves prognosis.

Key words

IgA vasculitis with nephritis / Crescent / Treatment strategy / Prognosis / Kunxian capsule / Child

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Qiu-Shuang ZHANG , Xiao-Qing YANG , Xiao-Feng MEI , et al . Pathological characteristics, therapeutic strategies, and prognostic assessment in children with crescentic IgA vasculitis with nephritis[J]. Chinese Journal of Contemporary Pediatrics. 2026, 28(9): 1086-1092 https://doi.org/10.7499/j.issn.1008-8830.2605065

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