Comparison of lupus patients with early and late onset nephritis: a study in 71 patients from a single referral center

Abstract

Background: Nephritis occurs frequently in systemic lupus erythematosus (SLE) and may worsen disease morbidity and mortality. Knowing all characteristics of this manifestation helps to a prompt recognition and treatment. Aim: To compare the differences in clinical data, serological profile and treatment response of nephritis of early and late onset. Methods: Retrospective study of 71 SLE patients with biopsy proven nephritis divided in early nephritis group (diagnosis of nephritis in the first 5 years of the disease) and late nephritis (diagnosis of nephritis after 5 years). Epidemiological, serological, clinical and treatment data were collected from charts and compared. Results: In this sample, 70. 4% had early onset nephritis and 29.6% had late onset. No differences were noted in epidemiological, clinical, serological profile, SLICC and SLEDAI, except that late onset nephritis patients were older at nephritis diagnosis (p = 0.01). Regarding renal biopsy classification, C3 and C4 levels, serum creatinine, 24 h proteinuria and response rate to treatment the two groups were similar (p = NS). Patients with early onset had lower levels of hemoglobin at nephritis onset than those of late onset (p = 0.02). Conclusions: Most of SLE patients had nephritis in the first 5 years of disease. No major differences were noted when disease profile or treatment outcome of early and late onset nephritis were compared.

Comparison of complete renal response and mortality in early- and late-onset lupus nephritis: A multicenter retrospective study of a Japanese cohort

“…The studies' conclusions varied and are controversial; Varela et al compared early-onset and late-onset LN and reported no signi cant difference in nephritis development or histological type [10], and Ugolini-Lopes et al observed no differences in serum Cr levels or the prevalence of ESKD or mortality after 7 years of follow-up [11]. A recent investigation comparing the disease pro les and outcomes of early-onset and late-onset LN patients did not reveal any signi cant differences [17]. However, these reports lack treatment information and clinicopathological considerations (including the index of activity and chronicity), which are study limitations.…”

“…5%-15% of LN cases developing later [2,26,27]. There are no standardized de nitions of early-onset and late-onset LN, but several studies made clinical comparisons separated by 5 years [10,11,17], and we followed that approach in the present work.…”

“…We divided the 201 patients into two groups: early-onset LN and late-onset LN. As in previous studies [10,11,17], early-onset was de ned as the development of LN within 5 years of the patient's SLE diagnosis, and late-onset was de ned as the development of LN >5 years after the patient's SLE diagnosis. Some of the patients provided written informed consent for the use of their data, and the opt-out strategy was used by the remainder of the patients.…”

Comparison of complete renal response and mortality in early- and late-onset lupus nephritis: a multicenter retrospective study of a Japanese cohort

“…The studies' conclusions varied and are controversial; Varela et al compared early-onset and late-onset LN and reported no significant difference in nephritis development or histological type [10], and Ugolini-Lopes et al observed no differences in serum Cr levels or the prevalence of ESKD or mortality after 7 years of follow-up [11]. A recent investigation comparing the disease profiles and outcomes of early-onset and late-onset LN patients did not reveal any significant differences [17]. However, these reports lack treatment information and clinicopathological considerations (including the index of activity and chronicity), which are study limitations.…”

“…We divided the 201 patients into two groups: early-onset LN and late-onset LN. As in previous studies [10,11,17], early onset was defined as the development of LN within 5 years of the patient's SLE diagnosis, and late onset was defined as the development of LN > 5 years after the patient's SLE diagnosis. Some of the patients provided written informed consent for the use of their data, and the opt-out strategy was used by the remainder of the patients.…”