High Burden of Premature Arteriosclerosis on Renal Biopsy Results in Incident Lupus Nephritis.
High Burden of Premature Arteriosclerosis on Renal Biopsy Results in Incident Lupus Nephritis.
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DOI：
10.1002/acr.24138
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发表时间：
2021-03
影响因子：
4.7
通讯作者：
Panzer SE
中科院分区：
文献类型：
--
作者：
Garg S;Bartels CM;Hansen KE;Zhong W;Huang Y;Semanik MG;Smith M;Panzer SE
系统性红斑狼疮和狼疮性肾炎（LN）患者的心血管疾病（CVD）加速。尽管文献提示肾动脉硬化可预测其他肾小球肾炎疾病中的CVD，但LN活检中动脉硬化分级和报告可能特别被忽视。我们的目的是检查LN患者肾动脉硬化的负担，并评估LN活检中动脉硬化是否被低估。我们确定了1994年至2017年期间在学术中心接受肾活检的所有LN患者。我们对LN活检报告进行了解释，以将Banff分类为无、轻度、中度或重度肾动脉硬化。将肾动脉硬化的患病率与公布的年龄匹配的健康同龄人的患病率进行比较，并检查动脉硬化的预测因子。我们过度阅读活检的Banff肾动脉硬化分级并与病理报告进行比较。在189例LN患者中，肾动脉硬化的患病率比健康同龄人早20年，40%的31-39岁LN患者受影响，而50-59岁健康同龄人受影响的比例为44%。多变量分析显示，年龄≥30岁的LN患者发生肾动脉硬化的几率高3倍。活检结果显示LN慢性化预测肾动脉硬化的几率高4倍。过度阅读确定了50%的标准LN活检报告遗漏了肾动脉硬化的存在或不存在。LN患者的肾动脉硬化比健康同龄人快20年，并且在一半的常规活检报告中被病理学家忽视。我们建议在所有LN活检报告中纳入Banff肾动脉硬化分级。
Cardiovascular disease (CVD) is accelerated in patients with systemic lupus erythematosus and lupus nephritis (LN). Despite the literature suggesting that renal arteriosclerosis predicts CVD in other glomerulonephritis diseases, arteriosclerosis grading and reporting might be particularly overlooked in LN biopsies. Our objective was to examine the burden of renal arteriosclerosis in LN and to assess whether arteriosclerosis is underreported in LN biopsies. We identified all patients with LN undergoing kidney biopsy between 1994 and 2017 at an academic center. We interpreted LN biopsy reports to classify the Banff categories of absent, mild, moderate, or severe renal arteriosclerosis. The prevalence of renal arteriosclerosis was compared with the prevalence published for age-matched healthy peers, and predictors of arteriosclerosis were examined. We overread biopsies for Banff renal arteriosclerosis grading and compared to pathology reports. Among 189 incident patients with LN, renal arteriosclerosis prevalence was 2 decades earlier compared to their healthy peers, affecting 40% of patients ages 31–39 years with LN compared to 44% of healthy peers ages 50–59 years. A multivariable analysis showed a 3-fold higher odds of renal arteriosclerosis in patients ages ≥30 years with LN. LN chronicity on biopsy results predicted a 4-fold higher odds of renal arteriosclerosis. The overreads determined that 50% of standard LN biopsy reports missed reporting the presence or absence of renal arteriosclerosis. Renal arteriosclerosis is accelerated by 2 decades in patients with LN compared to their healthy peers and is overlooked by pathologists in half of the routine biopsy reports. We propose incorporating Banff renal arteriosclerosis grading in all LN biopsy reports.
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影响因子：
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作者：
Petri, Michelle;Orbai, Ana-Maria;Alarcon, Graciela S.;Gordon, Caroline;Merrill, Joan T.;Fortin, Paul R.;Bruce, Ian N.;Isenberg, David;Wallace, Daniel J.;Nived, Ola;Sturfelt, Gunnar;Ramsey-Goldman, Rosalind;Bae, Sang-Cheol;Hanly, John G.;Sanchez-Guerrero, Jorge;Clarke, Ann;Aranow, Cynthia;Manzi, Susan;Urowitz, Murray;Gladman, Dafna;Kalunian, Kenneth;Costner, Melissa;Werth, Victoria P.;Zoma, Asad;Bernatsky, Sasha;Ruiz-Irastorza, Guillermo;Khamashta, Munther A.;Jacobsen, Soren;Buyon, Jill P.;Maddison, Peter;Dooley, Mary Anne;van vollenhoven, Ronald F.;Ginzler, Ellen;Stoll, Thomas;Peschken, Christine;Jorizzo, Joseph L.;Callen, Jeffrey P.;Lim, S. Sam;Fessler, Barri J.;Inanc, Murat;Kamen, Diane L.;Rahman, Anisur;Steinsson, Kristjan;Franks, Andrew G., Jr.;Sigler, Lisa;Hameed, Suhail;Fang, Hong;Ngoc Pham;Brey, Robin;Weisman, Michael H.;McGwin, Gerald, Jr.;Magder, Laurence S.
通讯作者：
Magder, Laurence S.
影响因子：
24
作者：
Gerhard-Herman, Marie D.;Gornik, Heather L.;Walsh, M. Eileen
通讯作者：
Walsh, M. Eileen
影响因子：
39.2
作者：
Rule AD;Amer H;Cornell LD;Taler SJ;Cosio FG;Kremers WK;Textor SC;Stegall MD
通讯作者：
Stegall MD
影响因子：
37.8
作者：
Gibbons, RJ;Chatterjee, K;Smith, SC
通讯作者：
Smith, SC
影响因子：
8.3
作者：
Sacco, Ralph L.;Kasner, Scott E.;Vinters, Harry V.
通讯作者：
Vinters, Harry V.