Predictive factors for the development of lupus nephritis after diagnosis of systemic lupus erythematosus

Toro, Miguel; Ceballos, Iter Varela; Capote, Araceli Chico; Kokuina, Elena; Bruzón, Yeniset Sánchez; Figueredo, Nelsa Casas

doi:10.1016/j.reumae.2021.08.003

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…Our results were consistent with previous studies showing a higher prevalence of malar rash [17], serositis [18], pulmonitis [19], lymphadenopathy [20], necrotizing vasculitis [21], higher SLEDAI score [22], and lower prevalence of Raynaud's phenomenon [23], Sjogren's syndrome [24], and peripheral nervous system manifestations [25] in LN patients. SLE patients with LN had a higher frequency of arterial or venous thrombosis than non-renal SLE patients, while no differences were observed in regard to antiphospholipid syndrome and antiphospholipid antibodies positivity in line with literature data [26].…”

supporting

confidence: 93%

Lupus nephritis: clinical characteristics, serological associations, pattern of pro- and anti-inflammatory markers

Iaremenko

Koliadenko

Iaremenko³

et al. 2023

Ukr. J. Nephrol. and Dial.

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The present study aimed to investigate the prevalence, clinical, and laboratory characteristics of renal involvement in a large cohort of Ukrainian patients with systemic lupus erythematosus (SLE). Methods. A total of 380 patients with SLE were enrolled in this cross-sectional study, including 176 with lupus nephritis (LN) and 204 with non-renal SLE. Patients were reviewed for demographic details, clinical SLE manifestations, SLE Disease Activity Index 2000 (SLEDAI-2K), and SLICC/ACR Damage Index. Laboratory evaluations included complete blood count with an erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), anti-CRP antibodies, serum creatinine, complement C3 and C4 levels, urinalysis, 24-hour urine protein, specific autoantibodies, interleukin-6 (IL-6), IL-10. Results. There was a significantly higher frequency of malar rash, lymphadenopathy, splenomegaly, serositis, pulmonitis, fever, necrotizing vasculitis, and a history of arterial/venous thrombosis in patients with LN; while Raynaud’s phenomenon, Sjogren’s syndrome, peripheral nervous system manifestations occurred more often in patients with non-renal SLE. Patients with LN were found to have higher ESR levels and lower IL-10 levels. Either frequency of anti-dsDNA positivity and its titer were higher in the LN group with no differences regarding other autoantibodies. C3 and C4, CRP, hs-CRP, anti-CRP, and IL-6 levels showed no significant difference between the groups. Multivariate analysis demonstrated that LN was positively associated with pulmonitis (OR 5.34 (95% CI 1.88-15.10), p=0.002), arterial/venous thrombosis (OR 6.80 (95% CI 1.87-24.70), p=0.004), anti-dsDNA positivity (OR 6.22 (95% CI 1.89-20.50), p=0.003), higher SLEDAI-2K score (OR 1.15 (95% CI 1.08-1.23), p<0.001) and negatively associated with Raynaud’s syndrome (OR 0.20 (95% CI 0.08-0.49), p<0.001) and younger age at disease onset (OR 0.96 (95% CI 0.93-0.99), p=0.003). In the LN group, 27 patients (15.3%) had nephrotic syndrome. In multivariate logistic analysis, male sex (OR 5.21 (95% CI 1.77-15.30), p=0.003) and higher SLICC/ACR score (OR 2.12 (95% CI 1.45-3.09), p<0.001) were associated with increased risk of nephrotic syndrome, whereas lymphadenopathy (OR 0.31 (95% CI 0.12-0.80), p=0.02) was associated with decreased risk of nephrotic syndrome development. Conclusions. Our cohort of Ukrainian LN patients showed different characteristics in demographic, clinical, and laboratory findings compared to patients with non-renal SLE. These features are mostly on par with LN patients of other nationalities around the world.

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confidence: 93%

Lupus nephritis: clinical characteristics, serological associations, pattern of pro- and anti-inflammatory markers

Iaremenko

Koliadenko

Iaremenko³

et al. 2023

Ukr. J. Nephrol. and Dial.

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“…Loss of immune tolerance to endogenous nuclear material leads to the clinical symptoms ( 55 ). The progression of renal disease is the commonly used predictive source of morbidity and mortality in SLE patients ( 56 – 58 ). LN is one of the most severe organ manifestations and presents extensive kidney lesions, which is mainly manifested by the expansion of the glomerular mesangium and accumulation of extracellular matrix secreted from MCs.…”

Section: Pathological Injuries Of Mcs In Lnmentioning

confidence: 99%

Mesangial cell: A hub in lupus nephritis

et al. 2022

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Lupus nephritis (LN) is a severe renal disease caused by the massive deposition of the immune complexes (ICs) in renal tissue, acting as one of the significant organ manifestations of systemic lupus erythematosus (SLE) and a substantial cause of death in clinical patients. As mesangium is one of the primary sites for IC deposition, mesangial cells (MCs) constantly undergo severe damage, resulting in excessive proliferation and increased extracellular matrix (ECM) production. In addition to playing a role in organizational structure, MCs are closely related to in situ immunomodulation by phagocytosis, antigen-presenting function, and inflammatory effects, aberrantly participating in the tissue-resident immune responses and leading to immune-mediated renal lesions. Notably, such renal-resident immune responses drive a second wave of MC damage, accelerating the development of LN. This review summarized the damage mechanisms and the in situ immune regulation of MCs in LN, facilitating the current drug research for exploring clinical treatment strategies.

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Pediatric mixed connective tissue disease versus other overlap syndromes: a retrospective multicenter cohort study

et al. 2023

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Predictive factors for the development of lupus nephritis after diagnosis of systemic lupus erythematosus

Cited by 3 publications

References 28 publications

Lupus nephritis: clinical characteristics, serological associations, pattern of pro- and anti-inflammatory markers

Lupus nephritis: clinical characteristics, serological associations, pattern of pro- and anti-inflammatory markers

Mesangial cell: A hub in lupus nephritis

Pediatric mixed connective tissue disease versus other overlap syndromes: a retrospective multicenter cohort study

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