Long-Term Kidney Prognosis and Pathological Characteristics of Late-Onset Lupus Nephritis.
Long-Term Kidney Prognosis and Pathological Characteristics of Late-Onset Lupus Nephritis.
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晚发性狼疮性肾炎的长期肾脏预后及病理特征
DOI：
10.3389/fmed.2022.882692
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发表时间：
2022
影响因子：
3.9
通讯作者：
Chen, Wei
中科院分区：
文献类型：
--
作者：
Tian, Na;Zhou, Qian;Yin, PeiRan;Chen, WenFang;Hong, LingYao;Luo, QiMei;Chen, MengHua;Yu, XueQing;Chen, Wei
对晚发SLE患者的预后，尤其是肾功能的预后仍存在争议。本研究的目的是调查晚发性狼疮性肾炎（LN）患者的长期肾脏预后。在中国成人LN患者中进行了一项回顾性长期队列研究。将患者分为晚发（>50岁）和早发（<50岁）LN组。比较两组基线特征，尤其是肾脏病理特征。对该队列进行肾脏结局随访，定义为血清肌酐加倍或ESRD。采用考克斯回归分析晚发LN与预后的关系。共招募了1，264名患者，其中102名患者被分配为晚发性LN，1，162名患者被分配为早发性LN。晚发LN组较早发LN组肾功能差，慢性病变多。在55（3，207）个月的随访期间，114（13.1%）例死亡，107（12.2%）例肌酐加倍，80（9.1%）例发展为终末期肾病。晚发LN组的5年和10年生存率分别为67.6%和50.5%，明显低于早发LN组（分别为89.8%和84.6%）。然而，在肾脏存活率方面没有发现显著差异（对数秩卡方= 3.55，p = 0.06）。考克斯回归分析显示，迟发性LN是患者生存的独立危险因素（风险比= 3.03，95%CI（1.39，6.58），p = 0.005）。基线血清肌酐升高是晚发型LN患者肾脏存活的独立危险因素。晚发LN患者肾脏病理活动性病变轻，慢性病变重。他们的总体结局较差，但肾脏结局相对较好。ClinicalTrials.gov标识符：NCT 03001973，2016年12月22日追溯注册。
Arguments still exist on prognosis of late-onset SLE, especially their kidney function. The purpose of this study was to investigate long-term kidney outcomes in patients with late-onset lupus nephritis (LN). A retrospective long-term cohort study was conducted in adult Chinese patients with LN. The patients were divided into late- (>50 years) and early-onset (<50 years) LN groups. The baseline characteristics, especially the kidney pathological characteristics, were compared. The cohort was followed-up for kidney outcome defined as doubling of serum creatinine or ESRD. Cox regression analysis was used to examine the association between late onset LN and its outcomes. A total of 1,264 patients were recruited, who were assigned to late-onset LN with 102 patients and early-onset LN with 1,162 patients. The late-onset LN group showed a worse baseline kidney function and more chronic pathological lesions than the early-onset LN group. During a follow-up time of 55 (3, 207) months, 114 (13.1%) deaths occurred, 107 (12.2%) had doubling of creatinine, and 80 (9.1%) developed end-stage kidney disease. The 5- and 10-year survival rates of the late-onset LN group were 67.6 and 50.5%, respectively, which were much worse than those of the early-onset LN group (89.8 and 84.6%, respectively). However, no significant difference was found on kidney survival (log-rank chi-square = 3.55, p = 0.06). Cox regression analysis showed that late-onset LN was an independent risk factor for patient survival (hazard ratio = 3.03, 95% CI (1.39, 6.58), p = 0.005). Increased baseline serum creatinine was an independent risk factor for kidney survival of patients with late-onset LN. Patients with late-onset LN had milder active lesions but severer chronic lesions in kidney pathology. They have poorer overall outcome but relatively favorable kidney outcome. ClinicalTrials.gov Identifier: NCT03001973, 22 December 2016 retrospectively registered.
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影响因子：
5
作者：
Medlin JL;Hansen KE;Fitz SR;Bartels CM
通讯作者：
Bartels CM
影响因子：
2.3
作者：
Delfino, Juliana;Santos, Thiago Alberto F. G. dos;Skare, Thelma L.
通讯作者：
Skare, Thelma L.
DOI：
10.1111/j.1742-1241.2004.00283.x
发表时间：
2005-02-01
影响因子：
2.6
作者：
Sayarlioglu, M;Cefle, A;Konice, M
通讯作者：
Konice, M
影响因子：
2.6
作者：
Appenzeller, S.;Pereira, D. A.;Costallat, L. T. L.
通讯作者：
Costallat, L. T. L.
影响因子：
2.6
作者：
Voulgari, PV;Katsimbri, P;Drosos, AA
通讯作者：
Drosos, AA