Cargando…

Risk factors for subsequent lupus nephritis in patients with juvenile-onset systemic lupus erythematosus: a retrospective cohort study

BACKGROUND: Lupus nephritis (LN) is a crucial organ involvement in systemic lupus erythematosus (SLE). Patients with LN have higher morbidity and mortality rates than those without. Among all patients with LN, 20–40% had delayed onset, but the data for patients with juvenile-onset SLE (jSLE), who ha...

Descripción completa

Detalles Bibliográficos
Autores principales: Hsu, Tzu-Chuan, Yang, Yao-Hsu, Wang, Li-Chieh, Lee, Jyh-Hong, Yu, Hsin-Hui, Lin, Yu-Tsan, Hu, Ya-Chiao, Chiang, Bor-Luen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10039593/
https://www.ncbi.nlm.nih.gov/pubmed/36964531
http://dx.doi.org/10.1186/s12969-023-00806-x
_version_ 1784912302067154944
author Hsu, Tzu-Chuan
Yang, Yao-Hsu
Wang, Li-Chieh
Lee, Jyh-Hong
Yu, Hsin-Hui
Lin, Yu-Tsan
Hu, Ya-Chiao
Chiang, Bor-Luen
author_facet Hsu, Tzu-Chuan
Yang, Yao-Hsu
Wang, Li-Chieh
Lee, Jyh-Hong
Yu, Hsin-Hui
Lin, Yu-Tsan
Hu, Ya-Chiao
Chiang, Bor-Luen
author_sort Hsu, Tzu-Chuan
collection PubMed
description BACKGROUND: Lupus nephritis (LN) is a crucial organ involvement in systemic lupus erythematosus (SLE). Patients with LN have higher morbidity and mortality rates than those without. Among all patients with LN, 20–40% had delayed onset, but the data for patients with juvenile-onset SLE (jSLE), who have a higher percentage of LN than patients with adult-onset SLE (aSLE), were limited. This study aimed to determine the risk factors for subsequent LN in patients with jSLE. METHODS: A retrospective cohort study was conducted between 2008 and 2018 in a single tertiary medical centre. Patients with diagnosed jSLE were reviewed. We investigated those without LN at diagnosis and whether they developed LN afterward. The primary outcome was the development of subsequent LN. Clinical manifestations at diagnosis, serial laboratory data, and treatments were reviewed during follow-up periods. RESULTS: Among the 48 patients with jSLE without initial LN, 20 developed subsequent LN later (Group 1), whereas 28 remained free of LN (Group 2). There was no difference in the percentage of initial manifestations except for more discoid rashes in Group 2 patients. In the Cox regression model, elevated average anti-double-stranded DNA (dsDNA) antibody, low average serum complements, and high average erythrocyte sedimentation rate (ESR) levels during follow-up were predictors of subsequent LN. After adjusting for these factors in multivariable analyses, only high average anti-dsDNA antibody and high average ESR levels remained predictive of subsequent LN. For every 100 IU/ml increase in anti-dsDNA antibody, the risk for subsequent LN in jSLE increases by 1.29 times (hazard ratio = 1.29, 95% confidence interval 1.055–1.573). CONCLUSION: Persistently high anti-dsDNA antibody and ESR levels during the follow-up period were risk factors for subsequent LN in patients with jSLE. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12969-023-00806-x.
format Online
Article
Text
id pubmed-10039593
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-100395932023-03-26 Risk factors for subsequent lupus nephritis in patients with juvenile-onset systemic lupus erythematosus: a retrospective cohort study Hsu, Tzu-Chuan Yang, Yao-Hsu Wang, Li-Chieh Lee, Jyh-Hong Yu, Hsin-Hui Lin, Yu-Tsan Hu, Ya-Chiao Chiang, Bor-Luen Pediatr Rheumatol Online J Research Article BACKGROUND: Lupus nephritis (LN) is a crucial organ involvement in systemic lupus erythematosus (SLE). Patients with LN have higher morbidity and mortality rates than those without. Among all patients with LN, 20–40% had delayed onset, but the data for patients with juvenile-onset SLE (jSLE), who have a higher percentage of LN than patients with adult-onset SLE (aSLE), were limited. This study aimed to determine the risk factors for subsequent LN in patients with jSLE. METHODS: A retrospective cohort study was conducted between 2008 and 2018 in a single tertiary medical centre. Patients with diagnosed jSLE were reviewed. We investigated those without LN at diagnosis and whether they developed LN afterward. The primary outcome was the development of subsequent LN. Clinical manifestations at diagnosis, serial laboratory data, and treatments were reviewed during follow-up periods. RESULTS: Among the 48 patients with jSLE without initial LN, 20 developed subsequent LN later (Group 1), whereas 28 remained free of LN (Group 2). There was no difference in the percentage of initial manifestations except for more discoid rashes in Group 2 patients. In the Cox regression model, elevated average anti-double-stranded DNA (dsDNA) antibody, low average serum complements, and high average erythrocyte sedimentation rate (ESR) levels during follow-up were predictors of subsequent LN. After adjusting for these factors in multivariable analyses, only high average anti-dsDNA antibody and high average ESR levels remained predictive of subsequent LN. For every 100 IU/ml increase in anti-dsDNA antibody, the risk for subsequent LN in jSLE increases by 1.29 times (hazard ratio = 1.29, 95% confidence interval 1.055–1.573). CONCLUSION: Persistently high anti-dsDNA antibody and ESR levels during the follow-up period were risk factors for subsequent LN in patients with jSLE. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12969-023-00806-x. BioMed Central 2023-03-24 /pmc/articles/PMC10039593/ /pubmed/36964531 http://dx.doi.org/10.1186/s12969-023-00806-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Hsu, Tzu-Chuan
Yang, Yao-Hsu
Wang, Li-Chieh
Lee, Jyh-Hong
Yu, Hsin-Hui
Lin, Yu-Tsan
Hu, Ya-Chiao
Chiang, Bor-Luen
Risk factors for subsequent lupus nephritis in patients with juvenile-onset systemic lupus erythematosus: a retrospective cohort study
title Risk factors for subsequent lupus nephritis in patients with juvenile-onset systemic lupus erythematosus: a retrospective cohort study
title_full Risk factors for subsequent lupus nephritis in patients with juvenile-onset systemic lupus erythematosus: a retrospective cohort study
title_fullStr Risk factors for subsequent lupus nephritis in patients with juvenile-onset systemic lupus erythematosus: a retrospective cohort study
title_full_unstemmed Risk factors for subsequent lupus nephritis in patients with juvenile-onset systemic lupus erythematosus: a retrospective cohort study
title_short Risk factors for subsequent lupus nephritis in patients with juvenile-onset systemic lupus erythematosus: a retrospective cohort study
title_sort risk factors for subsequent lupus nephritis in patients with juvenile-onset systemic lupus erythematosus: a retrospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10039593/
https://www.ncbi.nlm.nih.gov/pubmed/36964531
http://dx.doi.org/10.1186/s12969-023-00806-x
work_keys_str_mv AT hsutzuchuan riskfactorsforsubsequentlupusnephritisinpatientswithjuvenileonsetsystemiclupuserythematosusaretrospectivecohortstudy
AT yangyaohsu riskfactorsforsubsequentlupusnephritisinpatientswithjuvenileonsetsystemiclupuserythematosusaretrospectivecohortstudy
AT wanglichieh riskfactorsforsubsequentlupusnephritisinpatientswithjuvenileonsetsystemiclupuserythematosusaretrospectivecohortstudy
AT leejyhhong riskfactorsforsubsequentlupusnephritisinpatientswithjuvenileonsetsystemiclupuserythematosusaretrospectivecohortstudy
AT yuhsinhui riskfactorsforsubsequentlupusnephritisinpatientswithjuvenileonsetsystemiclupuserythematosusaretrospectivecohortstudy
AT linyutsan riskfactorsforsubsequentlupusnephritisinpatientswithjuvenileonsetsystemiclupuserythematosusaretrospectivecohortstudy
AT huyachiao riskfactorsforsubsequentlupusnephritisinpatientswithjuvenileonsetsystemiclupuserythematosusaretrospectivecohortstudy
AT chiangborluen riskfactorsforsubsequentlupusnephritisinpatientswithjuvenileonsetsystemiclupuserythematosusaretrospectivecohortstudy