Long-term predictive value of acute kidney injury classification in diffuse proliferative lupus nephritis with acute kidney injury
Long-term predictive value of acute kidney injury classification in diffuse proliferative lupus nephritis with acute kidney injury
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急性肾损伤分类对弥漫性增生性狼疮肾炎合并急性肾损伤的长期预测价值
DOI：
10.1186/s12882-019-1676-4
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发表时间：
2020-01
期刊：
影响因子：
--
通讯作者：
Jingye Pan
中科院分区：
文献类型：
--
作者：
Tianxin Chen;Ying Zhou;Ji Zhang;Chaosheng Chen;Jingye Pan
基于“肾脏疾病：改善整体预后”（KDIGO） AKI诊断标准的急性肾损伤（AKI）分类的长期预测能力尚未在弥漫性增殖性狼疮性肾炎（DPLN）合并AKI患者中得到临床验证。我们的目的是评估KDIGO AKI分级对DPLN合并AKI患者的长期预测价值。方法回顾性队列分析温州医科大学第一附属医院2000年1月1日至2014年12月31日经活检证实的DPLN合并AKI患者的病历。进行多因素Cox回归和生存分析。结果共纳入167例DPLN患者，其中82例（49%）肾功能正常（No AKI）， 40例（24%）进入AKI-1期（AKI-1）， 26例（16%）进入AKI-2期（AKI-2）， 19例（16%）进入AKI-3期（AKI-3）。所有患者的平均随访时间为5.1±3.8年。所有患者无ESRD的5年生存率为86%，10年生存率为79%。无AKI患者10年无ESRD生存率为94.5%，AKI-1患者为81.8%，AKI-2患者为44.9%，AKI-3患者为14.6%。KDIGO AKI分类预测主要终点的ROC曲线下面积为0.83 (95% CI: 0.73-0.93) （P < 0.001）。在Cox回归分析中，AKI分期与主要终点独立相关，校正风险比（HR）为3.8（95% CI 2.1 ~ 6.7, P < 0.001）。结论基于KDIGO AKI分类的AKI严重程度与DPLN患者进展为ESRD相关。分析数据也证实了KDIGO AKI分类系统在预测DPLN合并AKI患者的长期预后方面具有良好的判别能力。
Abstract Background The long-term predictive ability of acute kidney injury (AKI) classification based on “Kidney Disease: Improving Global Outcomes”(KDIGO) AKI diagnosis criteria has not been clinically validated in diffuse proliferative lupus nephritis (DPLN) patients with AKI. Our objective was to assess the long-term predictive value of KDIGO AKI classification in DPLN patients with AKI. Methods Retrospective cohort study was conducted by reviewing medical records of biopsy-proven DPLN patients with AKI from the First Affiliated Hospital of Wenzhou Medical University between Jan 1, 2000 and Dec 31, 2014. Multivariate Cox regression and survival analysis were performed. Results One hundred sixty-seven DPLN patients were enrolled,82(49%) patients were normal renal function (No AKI), 40(24%) patients entered AKI-1 stage (AKI-1), 26(16%) patients entered AKI-2 stage (AKI-2) and 19(16%) patients entered AKI-3 stage (AKI-3). The mean follow-up of all patients was 5.1 ± 3.8 years. The patient survival without ESRD of all patients was 86% at 5 years and 79% at 10 years. The patient survival rate without ESRD at 10 yr was 94.5% for No AKI patients, 81.8% for AKI-1 patients, 44.9% for AKI-2 patients and 14.6% for AKI-3 patients. The area under the ROC curve for KDIGO AKI classification to predict the primary end point was 0.83 (95% CI: 0.73–0.93) ( P < 0.001). In Cox regression analysis, AKI stage was independently associated with primary endpoint, with an adjusted hazard ratio (HR) of 3.8(95% CI 2.1–6.7, P < 0.001). Conclusion Severity of AKI based on KDIGO AKI category was associated with progression to ESRD in DPLN patients. Analytical data also confirmed the good discriminative power of the KDIGO AKI classification system for predicting long-term prognosis of DPLN patients with AKI.
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影响因子：
5.5
作者：
通讯作者：
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影响因子：
27.4
作者：
Bertsias GK;Tektonidou M;Amoura Z;Aringer M;Bajema I;Berden JH;Boletis J;Cervera R;Dörner T;Doria A;Ferrario F;Floege J;Houssiau FA;Ioannidis JP;Isenberg DA;Kallenberg CG;Lightstone L;Marks SD;Martini A;Moroni G;Neumann I;Praga M;Schneider M;Starra A;Tesar V;Vasconcelos C;van Vollenhoven RF;Zakharova H;Haubitz M;Gordon C;Jayne D;Boumpas DT;European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association
通讯作者：
European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association
影响因子：
4.7
作者：
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.
通讯作者：
Grossman, Jennifer M.
影响因子：
158.5
作者：
Chan, TM;Li, FK;Lai, KN
通讯作者：
Lai, KN
影响因子：
19.6
作者：
Moroni, G;Quaglini, S;Ponticelli, C
通讯作者：
Ponticelli, C