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Comparison of clinical features and outcomes between patients with early and delayed lupus nephritis

BACKGROUND: Lupus nephritis is associated with increased risk of end-stage renal disease (ESRD) and all-cause mortality. We evaluated the clinical features and outcomes of patients with early and delayed lupus nephritis. METHODS: The medical records of 171 patients who met the 1997 revised classific...

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Autores principales: Ahn, Sung Soo, Yoo, Juyoung, Jung, Seung Min, Song, Jason Jungsik, Park, Yong-Beom, Lee, Sang-Won
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7341643/
https://www.ncbi.nlm.nih.gov/pubmed/32635898
http://dx.doi.org/10.1186/s12882-020-01915-5
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author Ahn, Sung Soo
Yoo, Juyoung
Jung, Seung Min
Song, Jason Jungsik
Park, Yong-Beom
Lee, Sang-Won
author_facet Ahn, Sung Soo
Yoo, Juyoung
Jung, Seung Min
Song, Jason Jungsik
Park, Yong-Beom
Lee, Sang-Won
author_sort Ahn, Sung Soo
collection PubMed
description BACKGROUND: Lupus nephritis is associated with increased risk of end-stage renal disease (ESRD) and all-cause mortality. We evaluated the clinical features and outcomes of patients with early and delayed lupus nephritis. METHODS: The medical records of 171 patients who met the 1997 revised classification criteria for systemic lupus erythematosus (SLE) with pathologic confirmation of lupus nephritis were reviewed. Early lupus nephritis was defined when lupus nephritis was histopathologically confirmed as the first clinical manifestation of SLE, whereas delayed lupus nephritis was defined as lupus nephritis that was identified after the diagnosis of SLE. Clinical and laboratory data, as well as kidney histopathology and medication usage were investigated. Kaplan-Meier and Cox-proportional hazard analysis was performed to compare the outcomes of early and delayed lupus nephritis and evaluate factors associated with ESRD and all-cause mortality. RESULTS: Patients with early lupus nephritis had higher disease activity (median non-renal SLE disease activity index-2000, 6.0 vs. 4.0; p < 0.001) and more frequent skin rash, oral ulcer and serositis; however, the proportion of patients with higher renal chronicity index was greater in the delayed lupus nephritis group (p = 0.007). Nevertheless, no difference was found regarding ESRD and all-cause mortality between the groups. In Cox-proportional hazard analysis, C-reactive protein level, creatinine level and chronicity index were factors associated with ESRD, while age and haemoglobin level were associated with all-cause mortality. CONCLUSIONS: In conclusion, clinical outcomes of early and delayed lupus nephritis are not significantly different. Rigorous adherence to current treatment recommendations is essential for the treatment of lupus nephritis.
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spelling pubmed-73416432020-07-14 Comparison of clinical features and outcomes between patients with early and delayed lupus nephritis Ahn, Sung Soo Yoo, Juyoung Jung, Seung Min Song, Jason Jungsik Park, Yong-Beom Lee, Sang-Won BMC Nephrol Research Article BACKGROUND: Lupus nephritis is associated with increased risk of end-stage renal disease (ESRD) and all-cause mortality. We evaluated the clinical features and outcomes of patients with early and delayed lupus nephritis. METHODS: The medical records of 171 patients who met the 1997 revised classification criteria for systemic lupus erythematosus (SLE) with pathologic confirmation of lupus nephritis were reviewed. Early lupus nephritis was defined when lupus nephritis was histopathologically confirmed as the first clinical manifestation of SLE, whereas delayed lupus nephritis was defined as lupus nephritis that was identified after the diagnosis of SLE. Clinical and laboratory data, as well as kidney histopathology and medication usage were investigated. Kaplan-Meier and Cox-proportional hazard analysis was performed to compare the outcomes of early and delayed lupus nephritis and evaluate factors associated with ESRD and all-cause mortality. RESULTS: Patients with early lupus nephritis had higher disease activity (median non-renal SLE disease activity index-2000, 6.0 vs. 4.0; p < 0.001) and more frequent skin rash, oral ulcer and serositis; however, the proportion of patients with higher renal chronicity index was greater in the delayed lupus nephritis group (p = 0.007). Nevertheless, no difference was found regarding ESRD and all-cause mortality between the groups. In Cox-proportional hazard analysis, C-reactive protein level, creatinine level and chronicity index were factors associated with ESRD, while age and haemoglobin level were associated with all-cause mortality. CONCLUSIONS: In conclusion, clinical outcomes of early and delayed lupus nephritis are not significantly different. Rigorous adherence to current treatment recommendations is essential for the treatment of lupus nephritis. BioMed Central 2020-07-07 /pmc/articles/PMC7341643/ /pubmed/32635898 http://dx.doi.org/10.1186/s12882-020-01915-5 Text en © The Author(s) 2020 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/. The Creative Commons Public Domain Dedication waiver (http://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
Ahn, Sung Soo
Yoo, Juyoung
Jung, Seung Min
Song, Jason Jungsik
Park, Yong-Beom
Lee, Sang-Won
Comparison of clinical features and outcomes between patients with early and delayed lupus nephritis
title Comparison of clinical features and outcomes between patients with early and delayed lupus nephritis
title_full Comparison of clinical features and outcomes between patients with early and delayed lupus nephritis
title_fullStr Comparison of clinical features and outcomes between patients with early and delayed lupus nephritis
title_full_unstemmed Comparison of clinical features and outcomes between patients with early and delayed lupus nephritis
title_short Comparison of clinical features and outcomes between patients with early and delayed lupus nephritis
title_sort comparison of clinical features and outcomes between patients with early and delayed lupus nephritis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7341643/
https://www.ncbi.nlm.nih.gov/pubmed/32635898
http://dx.doi.org/10.1186/s12882-020-01915-5
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