Comparison of clinical features and outcomes between patients with early and delayed lupus nephritis

Ahn, Sung Soo; Yoo, Juyoung; Jung, Seung Min; Song, Jason Jungsik; Park, Yong Bum; Lee, Sang Won

doi:10.1186/s12882-020-01915-5

Cited by 11 publications

(5 citation statements)

References 29 publications

(35 reference statements)

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“…Almost all the previous reports confirmed the high frequency of III, IV and V classes of LN in lateonset LN. [8][9][10][11]15 Our analysis of the clinical and laboratorial features of our 226 LN biopsy proven patients demonstrated that whether the nephritis onset is very early, early, medium, late and very late onset, these groups broadly share same clinical and serological characteristics although as above, Caucasian origin; arthritis and leucopaenia, seem to be more common in those patients whose renal disease becomes evident > 10 years after diagnosis.…”

Section: Discussionmentioning

confidence: 70%

“…Perhaps not surprisingly there are a number of differences amongst the previously reported series and in our experience. Tian et al 8 found no difference in terms of "kidney outcome comparing their early onset [less than 5 years] and late onset [more than 5 years] cases and these findings were reproduced by Ugoleni Lopez et al 9 and Ahn et al 10 . These data are broadly in line with our own results although the trend to end-stage renal disease in those whose nephritis diagnosis began more than 15 years after diagnosis was high [5 out of 10, 50%] compared to those whose nephritis began earlier [28 out of 216, 13%].…”

Section: Discussionmentioning

confidence: 75%

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Very Late Onset Lupus Nephritis: Single-Centre Experience and A Review of the Literature

Rind¹,

Isenberg²

2023

MRAJ

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Background: In the majority of lupus patients, lupus nephritis (LN) develops within the first five years of diagnosis. Here we evaluated patients treated in our department during the past 40 years distinguishing those with very early onset [within one year of diagnosis]; early onset [ two to five years post diagnosis]; medium-term onset [between six to ten years after diagnosis]; late onset [presenting six to 15 years after diagnosis] and very late onset LN [presenting 16 years or later after diagnosis]. Early onset [ two to five years post diagnosis]; medium-term onset [between six to ten years after diagnosis]; late onset [presenting six to 15 years after diagnosis] and very late onset LN [presenting 16 years or later after diagnosis].early onset [within two years of diagnosis]; medium-term onset [between two and five years after diagnosis]; late onset [presenting five to ten years after diagnosis] and very late onset LN [presenting ten years after diagnosis]. Aim: To compare the differences in demography, clinical data, serological profile and follow up of patients with LN of early, medium, late and very late onset. Methods: This was a retrospective study of 226 systemic lupus erythematosus (SLE) patients with biopsy proven nephritis. We focused on a comparison of their epidemiology, serology, clinical and follow-up data. Results: We identified 97 (43%) very early-onset patients; 69 (31%) early-onset; 28 (12%) medium onset; 22 (10%) late-onset and 10 (4%) very late-onset LN patients. Comparing those patients whose LN was delayed by> 10 years post their lupus diagnosis compared to those with LN onset <10 years we found that these patients were statistically significantly more likely to be Caucasian [p=0.04]; to have arthritis [p=0.001] and to be leucopaenic [p=0.004]. There were no other difference between the groups. Among the 10 patients with very late onset LN there was an increase trend towards them having higher ANA titer (>1:640) [p=0,044] and having biopsy-proven combined type of LN (III+V, IV+V) [p=0.034]. Conclusion: Although the majority of SLE patients who get LN do so within 10 years of diagnosis in our experience 14% [approximately 1:7] developed renal involvement 10 years or more after SLE diagnosis. The observation emphasis the need to be vigilant when caring for SLE patients long term.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 75%

Very Late Onset Lupus Nephritis: Single-Centre Experience and A Review of the Literature

Rind¹,

Isenberg²

2023

MRAJ

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“…Moon, et al [35] reported that patients with delayedonset LN (de ined as newly developed LN after the onset of SLE) progressed more to CKD, than patients with initialonset LN (de ined as LN diagnosed at the time of SLE onset) (28% vs. 16%; p = 0,004), while Ahn, et al [52]. reported no difference in renal and overall survival rates between delayed-onset and initial-onset.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for chronic kidney disease and end-stage renal disease in patients with lupus nephritis: A retrospective cohort study

Braga¹,

Medeiros²,

Viana³

et al. 2021

J Clini Nephrol

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Background: Lupus Nephritis (LN) occurs in approximately half of all patients with Systemic Lupus Erythematosus (SLE) and it is the most common cause of morbidity and mortality in patients with SLE. Factors associated with poor renal outcome vary among studies, and researches coming from Brazil are scarce. Objectives: To identify the prognostic factors associated to the development of Chronic Kidney Disease (CKD) and End Stage Renal Disease (ESRD) in LN patients followed in a tertiary hospital. Design and Settings: We conducted a retrospective cohort study set in a tertiary hospital in Fortaleza, Ceará, Brazil. Methods: We compiled a total of 214 LN patients diagnosed between 1983 and 2015. Data was collected from medical records and further analyzed using logistic regression. Results: LN prevalence was 53.9%. The cohort had a mean follow-up of 11.2 years (SD ± 7.2 years). At the end of follow-up, 93 of 197 patients (47.2%) had CKD, and 49 of 191 (25.6%) were on regular dialysis. The main factors associated for developing CKD after logistic regression analysis were the following predictors: hypertension (HR 2.80; 95% CI 1.30-6.01; p = 0.008), time between diagnosis of SLE and diagnosis of LN (HR 0.98; 95% CI 0.97-0.99; p = 0.009) and discontinuation of medications (HR 2.41; 95% CI 1.08-5.37; p = 0.03). Conclusion: Hypertension, discontinuation of medications, and time between diagnosis of SLE and diagnosis of LN are independent variables associated with the development of CKD and ESDR in our study.

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“…12 Ahn et al stated that CRP levels may be a predictive marker for end-stage renal disease. 38 Furthermore, it seems that indices such as neutrophil-to-lymphocyte ratio (NLR, demonstrating increased values in LN) and platelet-to-lymphocyte ratio can demonstrate a positive correlation with CRP. 39 However, whether or not these relationships are maintained in the presence of anti-CRP antibodies (or influenced by the latter) could be a subject of future research.…”

Section: Anti-crp Antibodies In Lupus Nephritismentioning

confidence: 99%

A Review of Anti-C Reactive Protein Antibodies in Systemic Lupus Erythematosus

Richter

Burlui

Bratoiu

et al. 2021

Journal of Interdisciplinary Medicine

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Systemic lupus erythematosus (SLE), the prototype autoimmune disease, is characterized by the production of a plethora of autoantibodies with various roles in the development of disease-related tissue damage. C-reactive protein (CRP) is an acute phase reactant with a pentameric structure. Under acidic or alkaline conditions, or when urea levels are high and/or calcium levels are low, the pentamer (pCRP) dissociates irreversibly into monomeric CRP (mCRP) and exposes new epitopes (neo-CRP). Importantly, anti-mCRP (but not anti-pCRP) antibodies have been described in patients with SLE, their prevalence varying from 4% to 78% in different cohorts. Numerous studies have investigated the relationship between autoantibodies directed against CRP (anti-CRP) and disease activity as well as their association with lupus nephritis (LN), frequently reporting discrepant findings. The main objective of the present review is to describe the role of anti-mCRP antibodies in SLE according to the currently available data.

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Comparison of clinical features and outcomes between patients with early and delayed lupus nephritis

Cited by 11 publications

References 29 publications

Very Late Onset Lupus Nephritis: Single-Centre Experience and A Review of the Literature

Very Late Onset Lupus Nephritis: Single-Centre Experience and A Review of the Literature

Prognostic factors for chronic kidney disease and end-stage renal disease in patients with lupus nephritis: A retrospective cohort study

A Review of Anti-C Reactive Protein Antibodies in Systemic Lupus Erythematosus

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