Predictors of renal relapse in Korean patients with lupus nephritis who achieved remission six months following induction therapy
Predictors of renal relapse in Korean patients with lupus nephritis who achieved remission six months following induction therapy
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DOI：
10.1177/0961203313476357
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发表时间：
2013-04-01
期刊：
影响因子：
2.6
通讯作者：
Park, S-H
中科院分区：
文献类型：
--
作者：
Moon, S-J;Park, H. S.;Park, S-H
狼疮性肾炎（LN）患者的肾脏复发是肾功能不良的危险因素。因此，需要确定肾复发的临床和血清学危险因素。共有 108 名 LN 患者参与了这项研究。经过六个月的诱导治疗后，所有受试者均获得完全缓解或部分缓解。我们回顾性分析了他们的临床和实验室指标、最终肾功能和肾活检结果。 LN 诊断后的中位随访期为 81 个月。 36名患者出现肾病复发；分别有 38% 和 46% 的患者在实现肾病缓解后 5 年内发生这种情况，10 年内发生这种情况。完全缓解和部分缓解患者的复发率没有差异。持续缓解患者和复发患者的 LN 发病时的临床变量和肾活检结果也没有差异。系统性红斑狼疮 (SLE) 发病年龄较早（28 岁；HR 7.308，P = 0.001）、抗 Ro 抗体血清阴性（血清阴性与血清阳性；HR 3.514，P = 0.007）以及开始治疗后 6 个月时抗 dsDNA 抗体血清阳性的患者，肾复发的可能性显着较高。 诱导治疗（HR 8.269，P = 0.001）。我们的研究表明，SLE 早期发病、抗 Ro 抗体血清阴性以及六个月诱导治疗后抗 dsDNA 抗体增加独立预测 LN 患者的肾复发。狼疮 (2013) 22, 527-537。
Renal relapse in patients with lupus nephritis (LN) is a risk factor for poor renal function. Therefore, there is a need to identify clinical and serological risk factors for renal relapse. A total of 108 patients with LN were enrolled in this study. All the subjects had achieved complete remission or partial remission following six months of induction therapy. We retrospectively analyzed their clinical and laboratory indices, final renal function, and kidney biopsy findings. The median follow-up period after LN diagnosis was 81 months. Renal relapse had occurred in 36 patients; it occurred in 38% and 46% of patients within five and 10 years after achievement of renal remission, respectively. There was no difference between the relapsed rate in patients with complete remission and that in those with partial remission. Clinical variables at LN onset and renal biopsy findings in the patients with sustained remission and relapsed patients were also not different. The probability of renal relapse was significantly higher in patients with an earlier age of onset of systemic lupus erythematosus (SLE) ( 28 years; HR 7.308, P = 0.001), seronegativity for anti-Ro antibody (seronegativity versus seropositivity; HR 3.514, P = 0.007), and seropositivity for anti-dsDNA antibody at six months after initiation of induction therapy (HR 8.269, P = 0.001). Our study demonstrated that early onset of SLE, seronegativity for anti-Ro antibody and increased anti-dsDNA antibody following six months of induction therapy independently predict renal relapse among the LN patients. Lupus (2013) 22, 527-537.