Antiphospholipid Antibodies and Renal Outcomes in Patients with Lupus Nephritis

Tsuruta, Yuki; Uchida, Keiko; Itabashi, Mitsuyo; Yumura, Wako; Nitta, Kosaku

doi:10.2169/internalmedicine.48.2363

Cited by 12 publications

(7 citation statements)

References 30 publications

(16 reference statements)

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“…7 Among the predictive factors for development of CKD, eGFR at presentation and presence of hypertension were reported. 28 Of all our patients, 47.9% had hypertension. This is similar to the rate quoted for LN patients from the eastern region of Saudi Arabia (47%).…”

Section: Discussionmentioning

confidence: 73%

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Predictors of mortality and end stage renal disease in Saudi patients with lupus nephritis

Durahim

Ghamdi

Seraya

et al. 2011

Lupus

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The purpose of this study was to investigate the presentation and factors affecting outcome over a 9-year period in 99 consecutive Saudi patients with biopsy proven lupus nephritis (LN), 35.5% of whom had nephrotic range proteinuria, 46.8% had estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2) and 65.5% had histological class IV. The female:male ratio was 3.7:1. During the observation period, there were significant rises in eGFR (p = 0.005), C4 (p = 0.000) and significant decrease in 24-h urine protein (p = 0.028). No correlation was found between final eGFR and baseline 24-h protein, anti-DNA, C3 or C4. Female patients had a significantly higher rise in eGFR (p = 0.05).During follow-up (FU), 28.2% required dialysis. The survival rates at 5, 10 and 15 years were 92%, 77% and 77% respectively. Baseline C3 and C4 levels were significantly lower in the patients who died (p = 0.0001 and 0.02 respectively). Those who required dialysis were more likely to die (p < 0.000) (risk ratio = 4.46; 95% confidence interval 2.8-7.2). Hypertension at presentation was associated with lower baseline eGFR (p = 0.01) and final eGFR (p = 0.002) but did not affect the baseline proteinuria. Baseline eGFR of <60 ml/min/1.73 m(2) at presentation was associated with lower eGFR at end of FU (p = 0.000), higher activity score (p = 0.0001) and chronicity scores (p = 0.017).

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Section: Discussionmentioning

confidence: 73%

“…19 A higher prevalence of 41% was reported from Japan. 28 In this paper, it was reported that the frequency of class V lupus nephritis was lower in aPL antibody-positive patients than in aPL antibody-negative patients. 28 We found no such association.…”

Section: Discussionmentioning

confidence: 84%

Predictors of mortality and end stage renal disease in Saudi patients with lupus nephritis

Durahim

Ghamdi

Seraya

et al. 2011

Lupus

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“…A variety of renal manifestations, including intra-glomerular capillary thrombosis and nephropathy, have been reported in APLa positive SLE patients. However, the true significance of APLa on the progression of lupus nephritis is still controversial [11], [12], [13], [14].…”

Section: Introductionmentioning

confidence: 99%

The impact of antiphospholipid antibodies in children with lupus nephritis

Al‐Mayouf

Alsaleem

Al-Hussain

et al. 2015

International Journal of Pediatrics and Adolescent Medicine

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Background and objectivesTo evaluate the frequency of antiphospholipid antibodies (APLa) among patients with childhood lupus nephritis (cLN) and to assess their impact on long-term renal outcomes.Design and settingThis is an observational hospital based study.Patients and methodsPatients with cLN diagnosed by renal biopsy seen between January 2002 and June 2014 were included. APLa positivity was defined if detection was positive on 2 occasions 6–12 weeks apart during their follow up. Demographic features, age at disease onset, disease duration, follow-up duration and clinical and laboratory variables at the time of renal biopsy were collected. The renal biopsy was reviewed for the nephritis class, microthrombi, activity and chronicity indices. Renal outcome measures included the serum creatinine levels, protein/creatinine ratio and end stage renal disease (ESRD).ResultsFifty-nine, (49 female) patients with a mean age of 19.8 years and mean disease duration of 6.8 years were involved. APLa were detected in 46 (78%) patients. Twenty-two patients had class IV nephritis, which was more prevalent in APLa positive patients. The frequencies of class III and V nephritis was similar in 10 patients in each class (7 patients in each class with APLa). The presence of APLa did not correlate with nephritis activity or the chronicity indices. Microthrombosis was found in 10 patients, and 8 of them had APLa. Patients with APLa had a higher frequency of elevated serum creatinine and hypertension, 9 developed ESRD, and 7 had APLa. There was no statistically significant association between the presence of APLa and the accrual damage index and clinical manifestations. Furthermore, there was no association between APLa and other autoantibodies.ConclusionThe frequency of APLa in cLN was high. While the association is not statistically significant, APLa positive patients tend to develop renal microthrombi and are probably at higher risk of ESRD.

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“…In this study, we found that the positive rate of aPL was 48.2% in patients with LN, which was higher or similar to that reported in previous studies of patients with SLE/LN. 10–12 Given the high prevalence of aPL in patients with SLE, aPL may have some other clinical significance beyond thrombosis and pregnancy events. However, whether aPL are correlated with clinical activity, especially renal pathological activity in LN patients remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Association of antiphospholipid antibodies with clinical activity and renal pathological activity in patients with lupus nephritis

Zhang

Zhou

et al. 2021

Lupus

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Objectives This study aimed to investigate the association of antiphospholipid antibodies (aPL) with clinical activity and renal pathological activity in patients with lupus nephritis (LN). Methods Levels of anticardiolipin () antibodies, anti-β2-glycoprotein I (anti-β2-GPI) antibodies and lupus anticoagulant (LAC) were measured, and other clinical and pathological data were also obtained during the same period before renal biopsy. Results A total of 83 patients with LN were included in this study, 40 patients (48.2%) in the s positive group and 43 patients in the aPL negative group. LN patients with positive aPL had significantly higher SLEDAI (p = 0.012), more hematuria (p = 0.043), lower serum C3 (p = 0.003) and C4 (p = 0.014), and a higher pathological activity index (p = 0.012), more micro-thrombosis (p = 0.046) and more C3 deposits (p = 0.038) in the glomerulus than patients with negative aPL The level of IgG- was significantly correlated with SLEDAI and serum level of C3 (r = 0.44, p < 0.001; r = −0.39, p = 0.003, respectively). The level of IgM- was significantly correlated with SLEDAI, and serum levels of C3 and C4 (r = 0.27, p = 0.014; r = −0.22, p = 0.041; r = −0.23, p = 0.035, respectively). Conclusions Our work suggests that aPL, especially, are correlated with both clinical activity and renal pathological activity in patients with LN.

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Antiphospholipid Antibodies and Renal Outcomes in Patients with Lupus Nephritis

Abstract: Objective Previous studies have documented a high frequency of thrombotic events in lupus nephritis patients with antiphospholipid (aPL)

Cited by 12 publications

References 30 publications

Predictors of mortality and end stage renal disease in Saudi patients with lupus nephritis

Predictors of mortality and end stage renal disease in Saudi patients with lupus nephritis

The impact of antiphospholipid antibodies in children with lupus nephritis

Association of antiphospholipid antibodies with clinical activity and renal pathological activity in patients with lupus nephritis

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