Worse long-term renal outcome of lupus nephritis patients of African descent living in Europe.
Worse long-term renal outcome of lupus nephritis patients of African descent living in Europe.
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DOI：
10.1136/rmdopen-2022-002386
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发表时间：
2022-10
期刊：
影响因子：
6.2
通讯作者：
Houssiau, Frederic
中科院分区：
文献类型：
--
作者：
Enfrein, Antoine;Pirson, Valerie;Le Guern, Veronique;Karras, Adexandre;Tamirou, Farah;Costedoat-Chalumeau, Nathalie;Houssiau, Frederic
生活在欧洲的非洲裔患者的狼疮肾炎（LN）的预后尚未得到充分研究。在两所欧洲大学医院进行的回顾性研究中，我们比较了非洲裔和白种人LN患者的预后。缓解定义为尿蛋白/肌酐（uP/C）比值<0.5 g/g，血清肌酐值<基线的120%。肾脏复发定义为再次出现uP/C>1 g/g，导致重复肾活检和/或免疫抑制治疗改变。慢性肾脏疾病（CKD）定义为肾小球滤过率≤60ml /min/1.73 m2。通过医疗档案和/或羟氯喹水平测量对依从性进行回顾性评估。52例非裔患者和85例白种人患者纳入本分析。III类和孤立的V类LN在非洲裔患者中更为常见。首次肾脏缓解的时间在种族亚组之间没有差异。相比之下，非洲裔患者的肾脏耀斑更早，CKD更常见，耀斑后CKD的时间更短。在一项多变量分析中，非洲血统是CKD进展的独立危险因素。我们观察到两组患者的治疗依从性无显著差异。非洲裔LN患者的肾脏预后较差，主要原因是肾脏耀斑发生率较高。
Prognosis of lupus nephritis (LN) among patients of African descent living in Europe has been understudied. 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 m2. Adherence was retrospectively assessed through medical files and/or hydroxychloroquine level measurements. 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. LN patients of African descent have worse renal outcomes, mainly explained by a higher rate of renal flare.
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影响因子：
19.6
作者：
Contreras, G.;Lenz, O.;Smith-Norwood, B.
通讯作者：
Smith-Norwood, B.
影响因子：
2.6
作者：
Tamirou, F.;Costedoat-Chalumeau, N.;Houssiau, F. A.
通讯作者：
Houssiau, F. A.
影响因子：
2.6
作者：
Mody, P. G.;Mody, G. M.;Assounga, A.
通讯作者：
Assounga, A.
影响因子：
13.2
作者：
Nee, Robert;Martinez-Osorio, Jorge;Abbott, Kevin C.
通讯作者：
Abbott, Kevin C.
患有狼疮性肾炎的非裔美国人的终末期肾病与 APOL1 相关。
影响因子：
13.3
作者：
Freedman, Barry I.;Langefeld, Carl D.;Andringa, Kelly K.;Croker, Jennifer A.;Williams, Adrienne H.;Garner, Neva E.;Birmingham, Daniel J.;Hebert, Lee A.;Hicks, Pamela J.;Segal, Mark S.;Edberg, Jeffrey C.;Brown, Elizabeth E.;Alarcon, Graciela S.;Costenbader, Karen H.;Comeau, Mary E.;Criswell, Lindsey A.;Harley, John B.;James, Judith A.;Kamen, Diane L.;Lim, S. Sam;Merrill, Joan T.;Sivils, Kathy L.;Niewold, Timothy B.;Patel, Neha M.;Petri, Michelle;Ramsey-Goldman, Rosalind;Reveille, John D.;Salmon, Jane E.;Tsao, Betty P.;Gibson, Keisha L.;Byers, Joyce R.;Vinnikova, Anna K.;Lea, Janice P.;Julian, Bruce A.;Kimberly, Robert P.
通讯作者：
Kimberly, Robert P.