Long-term outcomes of lupus nephritis with low-level proteinuria : a multicenter, retrospective study
© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissionsoup.com..
OBJECTIVES: Reportedly, patients with lupus nephritis (LN) and low-level proteinuria have favorable short-term renal outcomes. We aimed to clarify the long-term renal outcomes and overall survival of them, and the significance of renal biopsy in the early phase with low-level proteinuria.
METHODS: We included 144 Japanese patients with biopsy-proven LN from ten hospitals. Low-level proteinuria was defined by a urine protein: creatinine ratio (UPCR) of ≤ 1 g/gCr based on previous reports. The outcomes were end-stage renal disease (ESRD) and death.
RESULTS: Compared with patients with high-level proteinuria (UPCR > 1), those with low-level proteinuria (n = 67 [46.5%]) had significantly improved renal function at the time of renal biopsy, and low activity index and chronicity index (CI) while the frequency of class III/IV was similar (79.1% vs 84.4%, p = 0.409). In patients with low-level proteinuria, cyclophosphamide usage was less, and the incidence of ESRD (3.0% vs 13.0%, p = 0.036) or death (3.0% vs 16.9%, p = 0.006) during the total observation period (median, 72 months) were low. Kaplan-Meier analysis showed significant differences in the incidence of ESRD and death between the groups. Multivariate Cox regression analysis revealed that the significant risk factors for ESRD were high CI and hypertension, whereas those for death were increased age and high-level proteinuria.
CONCLUSION: Patients with LN and low-level proteinuria had favorable long-term renal and life outcomes. As these patients have substantial active pathological lesions, renal biopsy in the early phase with low-level proteinuria could enable early diagnosis and treatment and thus improve prognosis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
Rheumatology (Oxford, England) - (2023) vom: 24. Nov. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zoshima, Takeshi [VerfasserIn] |
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| Anmerkungen: |
Date Revised 24.11.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1093/rheumatology/kead624 |
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NLM364922877 |
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| 100 | 1 | |a Zoshima, Takeshi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Long-term outcomes of lupus nephritis with low-level proteinuria |b a multicenter, retrospective study |
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| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a OBJECTIVES: Reportedly, patients with lupus nephritis (LN) and low-level proteinuria have favorable short-term renal outcomes. We aimed to clarify the long-term renal outcomes and overall survival of them, and the significance of renal biopsy in the early phase with low-level proteinuria | ||
| 520 | |a METHODS: We included 144 Japanese patients with biopsy-proven LN from ten hospitals. Low-level proteinuria was defined by a urine protein: creatinine ratio (UPCR) of ≤ 1 g/gCr based on previous reports. The outcomes were end-stage renal disease (ESRD) and death | ||
| 520 | |a RESULTS: Compared with patients with high-level proteinuria (UPCR > 1), those with low-level proteinuria (n = 67 [46.5%]) had significantly improved renal function at the time of renal biopsy, and low activity index and chronicity index (CI) while the frequency of class III/IV was similar (79.1% vs 84.4%, p = 0.409). In patients with low-level proteinuria, cyclophosphamide usage was less, and the incidence of ESRD (3.0% vs 13.0%, p = 0.036) or death (3.0% vs 16.9%, p = 0.006) during the total observation period (median, 72 months) were low. Kaplan-Meier analysis showed significant differences in the incidence of ESRD and death between the groups. Multivariate Cox regression analysis revealed that the significant risk factors for ESRD were high CI and hypertension, whereas those for death were increased age and high-level proteinuria | ||
| 520 | |a CONCLUSION: Patients with LN and low-level proteinuria had favorable long-term renal and life outcomes. As these patients have substantial active pathological lesions, renal biopsy in the early phase with low-level proteinuria could enable early diagnosis and treatment and thus improve prognosis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a lupus nephritis | |
| 650 | 4 | |a proteinuria | |
| 650 | 4 | |a renal biopsy | |
| 700 | 1 | |a Hara, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Suzuki, Kazuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Yoshida, Misaki |e verfasserin |4 aut | |
| 700 | 1 | |a Konishi, Masahiro |e verfasserin |4 aut | |
| 700 | 1 | |a Hibino, Shinya |e verfasserin |4 aut | |
| 700 | 1 | |a Suda, Takuya |e verfasserin |4 aut | |
| 700 | 1 | |a Hoshiba, Ryohei |e verfasserin |4 aut | |
| 700 | 1 | |a Kawahara, Hiroyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Horita, Shigeto |e verfasserin |4 aut | |
| 700 | 1 | |a Nuka, Hiromi |e verfasserin |4 aut | |
| 700 | 1 | |a Mizushima, Ichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Kawano, Mitsuhiro |e verfasserin |4 aut | |
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