Renal Histopathology Associated With Kidney Failure and Mortality in Patients With Lupus Nephritis : A Long-Term Real-World Data Study
Copyright © 2023 by the Journal of Rheumatology..
OBJECTIVE: Lupus nephritis (LN), a common manifestation of systemic lupus erythematosus, is associated with a higher risk of kidney failure and death. The renal pathology of LN helps elucidate the severity of inflammation and the extent of irreversible damage. We aimed to identify histologic variables that correlate with risks of kidney failure and mortality.
METHODS: Between 2006 and 2019, a total of 526 patients with LN were enrolled. Renal pathology was classified according to the International Society of Nephrology/Renal Pathology Society classification. Components of activity and chronicity indices were analyzed to determine which variables correlated with an increased risk of kidney failure and death, with the adjustment of potential confounders.
RESULTS: During the follow-up period (median 7.5, IQR 3.5-10.7 years), 58 patients progressed to kidney failure and 64 died. In the multivariate Cox regression analysis, tubular atrophy (hazard ratio [HR] 2.28, 95% CI 1.66-3.14) and tubulointerstitial inflammation (HR 3.13, 95% CI 1.34-7.33) predicted kidney failure. The renal outcome was even worse if tubular atrophy and tubulointerstitial inflammation coexisted (10-year kidney survival rate: 63.22%). The presence of cellular crescents was associated with an increased risk of death in male patients with LN (HR 1.91, 95% CI 1.02-3.57), whereas the presence of fibrous crescents predicted death in female patients with LN (HR 5.70, 95% CI 1.61-20.25).
CONCLUSION: Histologic variables of renal biopsy in LN could be regarded as prognostic indicators for kidney failure and mortality.
| Errataetall: |
CommentIn: J Rheumatol. 2023 Sep;50(9):1095-1096. - PMID 37263655 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:50 |
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| Enthalten in: |
The Journal of rheumatology - 50(2023), 9 vom: 01. Sept., Seite 1127-1135 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Liao, Yu-Wan [VerfasserIn] |
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| Links: |
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| Themen: |
Histopathology |
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| Anmerkungen: |
Date Completed 04.09.2023 Date Revised 28.09.2023 published: Print-Electronic CommentIn: J Rheumatol. 2023 Sep;50(9):1095-1096. - PMID 37263655 Citation Status MEDLINE |
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| doi: |
10.3899/jrheum.220345 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM355084635 |
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| 100 | 1 | |a Liao, Yu-Wan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Renal Histopathology Associated With Kidney Failure and Mortality in Patients With Lupus Nephritis |b A Long-Term Real-World Data Study |
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| 500 | |a Date Revised 28.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Rheumatol. 2023 Sep;50(9):1095-1096. - PMID 37263655 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 by the Journal of Rheumatology. | ||
| 520 | |a OBJECTIVE: Lupus nephritis (LN), a common manifestation of systemic lupus erythematosus, is associated with a higher risk of kidney failure and death. The renal pathology of LN helps elucidate the severity of inflammation and the extent of irreversible damage. We aimed to identify histologic variables that correlate with risks of kidney failure and mortality | ||
| 520 | |a METHODS: Between 2006 and 2019, a total of 526 patients with LN were enrolled. Renal pathology was classified according to the International Society of Nephrology/Renal Pathology Society classification. Components of activity and chronicity indices were analyzed to determine which variables correlated with an increased risk of kidney failure and death, with the adjustment of potential confounders | ||
| 520 | |a RESULTS: During the follow-up period (median 7.5, IQR 3.5-10.7 years), 58 patients progressed to kidney failure and 64 died. In the multivariate Cox regression analysis, tubular atrophy (hazard ratio [HR] 2.28, 95% CI 1.66-3.14) and tubulointerstitial inflammation (HR 3.13, 95% CI 1.34-7.33) predicted kidney failure. The renal outcome was even worse if tubular atrophy and tubulointerstitial inflammation coexisted (10-year kidney survival rate: 63.22%). The presence of cellular crescents was associated with an increased risk of death in male patients with LN (HR 1.91, 95% CI 1.02-3.57), whereas the presence of fibrous crescents predicted death in female patients with LN (HR 5.70, 95% CI 1.61-20.25) | ||
| 520 | |a CONCLUSION: Histologic variables of renal biopsy in LN could be regarded as prognostic indicators for kidney failure and mortality | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a histopathology | |
| 650 | 4 | |a kidney failure | |
| 650 | 4 | |a lupus nephritis | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a systemic lupus erythematosus | |
| 700 | 1 | |a Chen, Yi-Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Hsieh, Tsu-Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Hung, Wei-Ting |e verfasserin |4 aut | |
| 700 | 1 | |a Hsu, Chiann-Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Wen, Mei-Chin |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Yi-Hsing |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Wen-Nan |e verfasserin |4 aut | |
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