Outcomes in African Americans and Hispanics with lupus nephritis
Outcomes in African Americans and Hispanics with lupus nephritis
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DOI：
10.1038/sj.ki.5000243
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发表时间：
2006-05-01
影响因子：
19.6
通讯作者：
Smith-Norwood, B.
中科院分区：
文献类型：
--
作者：
Contreras, G.;Lenz, O.;Smith-Norwood, B.
与白种人相比，非洲裔美国人和西班牙裔美国人狼疮肾炎的预后较差。本回顾性分析的目的是确定非裔美国人和西班牙裔美国人狼疮肾炎预后的独立预测因素。总共研究了93名非洲裔美国人、100名西班牙裔美国人和20名高加索人，他们的平均年龄为28713岁，家庭年收入为32.9±17.3（以1000美元计）。世界卫生组织（WHO）的狼疮性肾炎II、III、IV和V级分别为9,13,52和26%。重要的基线差异是非洲裔美国人的平均动脉压（MAP）高于西班牙裔和高加索人（107 +/- 19,102 +/- 15和99 +/- 13mmHg， P < 0.05），血清肌酐（1.66 +/- 1.3,1.25 +/- 1.0和1.31 +/- 1.0mg/dl, P < 0.025）。非裔美国人的红细胞压积比西班牙裔和白种人低（分别为2975、31 +/- 6%和32 +/- 7%，P < 0.05），且家庭年收入低于1000美元（30.8 +/- 14.9、33.1 +/- 15.9和42.2 +/- 29.3,P < 0.05）。与西班牙裔（57%,P = 0.03）和非洲裔美国人（51%,P = 0.09）相比，白种人（30%）的WHO IV类患病率较低。非裔美国人和西班牙裔美国人罹患双倍肌酐或终末期肾脏疾病的比例高于白种人（31,18和10%，P < 0.05），肾脏事件或死亡的比例也高于白种人（33,20和10%，P < 0.025）。我们的研究结果表明，表明侵袭性疾病和低家庭收入的生物学因素在非洲裔美国人和西班牙裔狼疮性肾炎患者中很常见，这些人群的预后比白种人更差。
Poor outcomes have been reported in African Americans and Hispanics compared to Caucasians with lupus nephritis. The purpose of this retrospective analysis was to identify independent predictors of outcomes in African Americans and Hispanics with lupus nephritis. In total, 93 African Americans, 100 Hispanics, and 20 Caucasians with a mean age of 28713 years and an annual household income of 32.9 +/- 17.3 ( in $ 1000) were studied. World Health Organization ( WHO) lupus nephritis classes II, III, IV, and V were seen in 9, 13, 52, and 26%, respectively. Important baseline differences were higher mean arterial pressure ( MAP) in African Americans compared to Hispanics and Caucasians ( 107 +/- 19, 102 +/- 15, and 99 +/- 13mmHg, P < 0.05), and higher serum creatinine (1.66 +/- 1.3, 1.25 +/- 1.0, and 1.31 +/- 1.0mg/dl, P < 0.025). African Americans had lower hematocrit compared to Hispanics and Caucasians ( 2975, and 31 +/- 6, and 32 +/- 7%, P < 0.05), and lower annual household income (30.8 +/- 14.9, 33.1 +/- 15.9, and 42.2 +/- 29.3 in $ 1000; P < 0.05). Lower prevalence of WHO class IV was seen in Caucasians ( 30%) compared to Hispanics (57%, P = 0.03) and African Americans (51%, P = 0.09). Development of doubling creatinine or end-stage renal disease was higher in African Americans and Hispanics than in Caucasians ( 31, 18, and 10%; P < 0.05), as was the development of renal events or death ( 34, 20, and 10%; P < 0.025). Our results suggest that both biological factors indicating an aggressive disease and low household income are common in African Americans and Hispanics with lupus nephritis, and outcomes in these groups are worse than in Caucasians.