Brief Report: Tubulointerstitial Damage in Lupus Nephritis: A Comparison of the Factors Associated With Tubulointerstitial Inflammation and Renal Scarring.
Brief Report: Tubulointerstitial Damage in Lupus Nephritis: A Comparison of the Factors Associated With Tubulointerstitial Inflammation and Renal Scarring.
复制标题
DOI：
10.1002/art.40575
复制
发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
Broder A
中科院分区：
文献类型：
--
作者：
Londoño Jimenez A;Mowrey WB;Putterman C;Buyon J;Goilav B;Broder A
表征和比较狼疮性肾炎（LN）患者的小管间质炎症（TII）和小管间质瘢痕（定义为间质纤维化和/或小管萎缩（IF/TA））相关因素。我们确定了2005年至2017年间肾活检与LN一致的SLE患者。从医疗记录中收集临床数据。拟合多变量logistic回归模型来评估与TII和IF/TA相关的因素（中度至重度vs.无或轻度）。在纳入的203例LN患者中，41例（20%）患者患有中重度TII， 45例（22%）患者患有中重度IF/TA， 21例（10%）患者两者兼有。多变量logistic回归模型显示，中重度TII与病程较短、黑种人、增生性LN、活检时eGFR<60 mL/min/1.73m2相关。羟氯喹的使用与中重度TII发生率显著降低相关，OR=0.27, 95% CI (0.10, 0.70), p=0.008。与TII类似，与中重度IF/TA相关的因素包括增生性LN，活检时eGFR<60 mL/min/1.73m2。此外，中重度TII和年龄的存在也与中重度IF/TA相关。常规血清学标志物，包括抗dsdna、抗ro /La抗体和低补体均与小管间质损伤（TID）无关。羟氯喹的使用与较少的炎症密切相关，而TII、增生性LN和低eGFR的发现是小管间质瘢痕存在的主要决定因素。确定可改变的因素对于制定更好的预防和治疗策略至关重要，这些策略旨在最终改善狼疮相关肾脏疾病患者的生存。
To characterize and compare the factors associated with tubulointerstitial inflammation (TII) and tubulointerstitial scarring, defined as interstitial fibrosis and/or tubular atrophy (IF/TA), in patients with lupus nephritis (LN). We identified SLE patients with a renal biopsy consistent with LN between 2005 and 2017. Clinical data was collected from the medical records. Multivariable logistic regression models were fitted to assess factors associated with TII and with IF/TA (moderate-to-severe vs. none-or-mild). Of 203 LN patients included, 41 patients (20%) had moderate-to-severe TII, 45 (22%) had moderate-to-severe IF/TA and 21 (10%) patients had both. Multivariable logistic regression models showed that moderate-to-severe TII was associated with a shorter disease duration, Black race, proliferative LN, and eGFR<60 mL/min/1.73m2 at the time of biopsy. Hydroxychloroquine use was associated with significantly lower odds of moderate-to-severe TII, OR=0.27, 95% CI (0.10, 0.70), p=0.008. Similar to TII, factors associated with moderate-to-severe IF/TA included proliferative LN, and eGFR<60 mL/min/1.73m2 at the time of biopsy. In addition, the presence of moderate-to-severe TII and older age were also associated with moderate-to-severe IF/TA. None of the routinely available serologic markers, including anti-dsDNA, anti-Ro/La antibodies and low complement were associated with tubulointerstitial damage (TID). The use of hydroxychloroquine was strongly associated with less inflammation, while the finding of TII, proliferative LN, and low eGFR were the major determinants of the presence of tubulointerstitial scarring. Identifying modifiable factors is critical for the development of better preventive and therapeutic strategies directed towards ultimate improvement in survival in patients with lupus-related kidney disease.
登录
查看更多内容
影响因子：
3.3
作者：
Clark MR;Trotter K;Chang A
通讯作者：
Chang A
影响因子：
--
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：
2.5
作者：
Pagni, Fabio;Galimberti, Stefania;Ferrario, Franco
通讯作者：
Ferrario, Franco
影响因子：
--
作者：
Benigni, Ariela;Caroli, Cristina;Remuzzi, Giuseppe
通讯作者：
Remuzzi, Giuseppe
影响因子：
--
作者：
Fessler, BJ;Alarcón, GS;Reveille, JD
通讯作者：
Reveille, JD