549 A systematic review of urine biomarkers in children with IgA vasculitis nephritis

Background Nephritis is a recognised complication of IgA vasculitis (IgAV, Henoch-Schoenlein purpura, HSP) and contributes to 1–2% of all chronic kidney disease (CKD). Improved detection and understanding of kidney inflammation may reduce irreversible kidney damage in IgA vasculitis nephritis (IgAV-N). Objectives The primary aim of this study was to perform a comprehensive systematic review to evaluate the current literature to identify promising urine biomarkers that can predict and assess the severity of kidney disease in children with IgAV. Methods A systematic literature review was performed using 4 search engines and a search term strategy with predefined inclusion and exclusion criteria. Promising biomarkers were divided in terms of clinical or pre-clinical and described using statistical significance and area under the curve (AUC) values. Results 121 studies were identified and thirteen were eligible for inclusion. A total of 2,446 paediatric patients were included; 51% male, median age 7.9 years (range not available). This comprised of healthy controls (n=761), children with IgAV-N (n=1,236) and children with IgAV without nephritis (IgAV-noN, n=449). The clinical markers for assessing severity of nephritis, 24-hour protein quantity, urine protein:creatinine ratio were both acceptable (AUC Conclusions Further longitudinal studies are needed to assess whether these biomarkers enhance standard of care in the management of IgAV-N.