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Worse long-term renal outcome of lupus nephritis patients of African descent living in Europe
INTRODUCTION: Prognosis of lupus nephritis (LN) among patients of African descent living in Europe has been understudied. METHODS: In a retrospective study performed in two European university hospitals, we compared the prognosis of LN in patients of African descent or Caucasians. Remission was defi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608524/ https://www.ncbi.nlm.nih.gov/pubmed/36283757 http://dx.doi.org/10.1136/rmdopen-2022-002386 |
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author | Enfrein, Antoine Pirson, Valérie Le Guern, Véronique Karras, Adexandre Tamirou, Farah Costedoat-Chalumeau, Nathalie Houssiau, Frederic |
author_facet | Enfrein, Antoine Pirson, Valérie Le Guern, Véronique Karras, Adexandre Tamirou, Farah Costedoat-Chalumeau, Nathalie Houssiau, Frederic |
author_sort | Enfrein, Antoine |
collection | PubMed |
description | INTRODUCTION: Prognosis of lupus nephritis (LN) among patients of African descent living in Europe has been understudied. METHODS: In a retrospective study performed in two European university hospitals, we compared the prognosis of LN in patients of African descent or Caucasians. Remission was defined as a urine protein to creatinine (uP/C) ratio<0.5 g/g and a serum creatinine value<120% of baseline. Renal relapse was defined as the reappearance of a uP/C>1 g/g, leading to a repeat kidney biopsy and/or immunosuppressive treatment change. Chronic kidney disease (CKD) was defined as estimated glomerular filtration rate≤60 mL/min/1.73 m(2). Adherence was retrospectively assessed through medical files and/or hydroxychloroquine level measurements. RESULTS: 52 patients of African descent and 85 Caucasian patients were included in this analysis. Class III and isolated class V LN were more common among patients of African descent. Time to first renal remission did not differ between ethnic subgroups. By contrast, patients of African descent suffered from earlier renal flares, CKD was more common and time to CKD was shorter after a flare. In a multivariate analysis, African ancestry was an independent risk factor for progression to CKD. We observed no significant difference in non-adherence to treatment between the two groups. CONCLUSION: LN patients of African descent have worse renal outcomes, mainly explained by a higher rate of renal flare. |
format | Online Article Text |
id | pubmed-9608524 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-96085242022-10-28 Worse long-term renal outcome of lupus nephritis patients of African descent living in Europe Enfrein, Antoine Pirson, Valérie Le Guern, Véronique Karras, Adexandre Tamirou, Farah Costedoat-Chalumeau, Nathalie Houssiau, Frederic RMD Open Lupus INTRODUCTION: Prognosis of lupus nephritis (LN) among patients of African descent living in Europe has been understudied. METHODS: In a retrospective study performed in two European university hospitals, we compared the prognosis of LN in patients of African descent or Caucasians. Remission was defined as a urine protein to creatinine (uP/C) ratio<0.5 g/g and a serum creatinine value<120% of baseline. Renal relapse was defined as the reappearance of a uP/C>1 g/g, leading to a repeat kidney biopsy and/or immunosuppressive treatment change. Chronic kidney disease (CKD) was defined as estimated glomerular filtration rate≤60 mL/min/1.73 m(2). Adherence was retrospectively assessed through medical files and/or hydroxychloroquine level measurements. RESULTS: 52 patients of African descent and 85 Caucasian patients were included in this analysis. Class III and isolated class V LN were more common among patients of African descent. Time to first renal remission did not differ between ethnic subgroups. By contrast, patients of African descent suffered from earlier renal flares, CKD was more common and time to CKD was shorter after a flare. In a multivariate analysis, African ancestry was an independent risk factor for progression to CKD. We observed no significant difference in non-adherence to treatment between the two groups. CONCLUSION: LN patients of African descent have worse renal outcomes, mainly explained by a higher rate of renal flare. BMJ Publishing Group 2022-10-25 /pmc/articles/PMC9608524/ /pubmed/36283757 http://dx.doi.org/10.1136/rmdopen-2022-002386 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Lupus Enfrein, Antoine Pirson, Valérie Le Guern, Véronique Karras, Adexandre Tamirou, Farah Costedoat-Chalumeau, Nathalie Houssiau, Frederic Worse long-term renal outcome of lupus nephritis patients of African descent living in Europe |
title | Worse long-term renal outcome of lupus nephritis patients of African descent living in Europe |
title_full | Worse long-term renal outcome of lupus nephritis patients of African descent living in Europe |
title_fullStr | Worse long-term renal outcome of lupus nephritis patients of African descent living in Europe |
title_full_unstemmed | Worse long-term renal outcome of lupus nephritis patients of African descent living in Europe |
title_short | Worse long-term renal outcome of lupus nephritis patients of African descent living in Europe |
title_sort | worse long-term renal outcome of lupus nephritis patients of african descent living in europe |
topic | Lupus |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608524/ https://www.ncbi.nlm.nih.gov/pubmed/36283757 http://dx.doi.org/10.1136/rmdopen-2022-002386 |
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