Predictors of kidney disease in a cohort of pediatric patients with lupus.
Predictors of kidney disease in a cohort of pediatric patients with lupus.
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DOI：
10.1177/0961203315570162
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发表时间：
2015-07
期刊：
影响因子：
2.6
通讯作者：
Furth SL
中科院分区：
文献类型：
--
作者：
Sule SD;Moodalbail DG;Burnham J;Fivush B;Furth SL
系统性红斑狼疮（SLE）儿童与成人相比，肾脏疾病的患病率增加。我们的目标是确定肾脏疾病的潜在临床和实验室预测因子。我们对年龄≤ 19岁的SLE患者进行了一项队列研究。还收集了从最初介绍到研究入组的回顾性数据。记录每次门诊访视的实验室和门诊数据，包括疾病活动指数、自身抗体、尿分析、血细胞计数和代谢特征。肾脏疾病被定义为存在异常肾活检或由美国流变学学院的病例定义为狼疮性肾炎。Logistic回归分析用于确定在SLE诊断后30天内有肾脏受累的患者的临床和实验室数据与肾脏疾病之间的相关性。我们还进行了事件发生时间分析，以确定肾脏疾病的前因。队列中随访了47名SLE儿童和青少年，91%为女性，68%为黑人。队列中的所有男性都发生了肾脏疾病，并且都是在诊断为SLE的一个月内。在逻辑回归分析中，低血清白蛋白（比值比：4.8，95%CI：1.9 - 12.5）和阳性dsDNA抗体（OR：3.2，95%CI：1.7 - 5.9）与肾脏疾病相关。在纵向分析中，孤立性无菌性脓尿（风险比（HR）：3，95% CI：1.1 - 6.4）和低血清白蛋白（HR：3.4，95% CI：1.7 - 6.9）是未来肾脏疾病的预测因子。抗Ro抗体的存在对肾脏疾病具有保护作用（HR：0.2，95% CI：0.05 - 0.5）。我们确定了与肾脏疾病相关的变量，包括SLE的初始诊断和SLE儿童队列的纵向随访。识别这些异常的实验室值可能有助于临床医生在发病前识别有肾脏疾病风险的患者，从而预防长期并发症。
Children with systemic lupus erythematosus (SLE) have an increased prevalence of kidney disease compared to their adult counterparts. Our goal was to identify potential clinical and laboratory predictors of renal disease. We performed a cohort study of incident and prevalent patients with SLE aged ≤ 19 years. Retrospective data from initial presentation until study enrollment was also collected. Laboratory and clinic data were recorded from each clinic visit including disease activity indices, autoantibodies, urinalyses, blood counts, and metabolic profile. Kidney disease was defined as the presence of abnormal renal biopsy or by American College of Rheumatology case definition for lupus nephritis. Logistic regression analyses were used to determine the association between clinical and laboratory data with kidney disease in those who had renal involvement within 30 days of SLE diagnosis. We also performed a time to event analysis to identify antecedents of renal disease. 47 children and adolescents with SLE were followed in the cohort, 91% female and 68% Black. All of the males in the cohort developed renal disease, and all within one month of the diagnosis of SLE. In logistic regression, low serum albumin (Odds Ratio: 4.8, 95% CI: 1.9–12.5) and positive dsDNA antibodies (OR: 3.2, 95% CI: 1.7–5.9) were associated with kidney disease. In longitudinal analyses, isolated sterile pyuria (Hazard Ratio (HR): 3, 95% CI: 1.1–6.4) and low serum albumin (HR: 3.4, 95% CI: 1.7–6.9) were predictors of future kidney disease. The presence of antibodies against Ro were protective against renal disease (HR: 0.2, 95% CI: 0.05–0.5). We identified variables associated with kidney disease, both at initial diagnosis of SLE and in longitudinal follow-up in a cohort of children with SLE. The recognition of these abnormal laboratory values may help clinicians identify patients at risk for kidney disease before its onset thus preventing long-term complications.
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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.
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Magder, Laurence S.
影响因子：
4.7
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Hahn, Bevra H.;McMahon, Maureen A.;Wilkinson, Alan;Wallace, W. Dean;Daikh, David I.;Fitzgerald, John D.;Karpouzas, George A.;Merrill, Joan T.;Wallace, Daniel J.;Yazdany, Jinoos;Ramsey-Goldman, Rosalind;Singh, Karandeep;Khalighi, Mazdak;Choi, Soo-In;Gogia, Maneesh;Kafaja, Suzanne;Kamgar, Mohammad;Lau, Christine;Martin, William J.;Parikh, Sefali;Peng, Justin;Rastogi, Anjay;Chen, Weiling;Grossman, Jennifer M.
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Grossman, Jennifer M.
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通讯作者：
Bernatsky, S.
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Moon, S-J;Park, H. S.;Park, S-H
通讯作者：
Park, S-H
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通讯作者：
Devarajan, Prasad