Disease activity of lupus nephritis with different pathological types and risk factors of end-stage renal disease: analysis of 305 cases

Di-san junyi daxue xuebao

WU Qijun¹  ZHANG Dongmei¹  ZHAI Zhifang¹  SONG Zhiqiang¹ 

[1] Department of Dermatology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China ;

关键词: lupus nephritis;    clinical features;    pathological types;    end-stage renal disease;    risk factor;   

DOI  :  10.16016/j.1000-5404.202007102

来源: DOAJ

【 摘 要 】

Objective To explore the relationship of lupus nephritis (LN) with different pathological types with disease activity and prognosis, and investigate the risk factors of end-stage renal disease (ESRD). Methods A total of 305 pathologically-confirmed LN patients admitted in our hospital from the year of 2013 to 2018 were retrospectively enrolled in this study. According to the results of renal biopsy, they were divided into mesangial hypercellularity LN (including 146 cases of LN-Ⅲ/Ⅳ and 106 cases of LN-Ⅲ/Ⅳ+Ⅴ) and non-mesangial hypercellularity LN (53 cases of LN-Ⅱ/Ⅴ). The disease activity and prognosis of the patients with different pathological types were compared, and the risk factors of ESRD were explored. Results There were more patients with Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) ≥10 (66.3% vs 45.3%), occurrences of serositis, hair loss, anemia, higher serum creatinine, hematuria, and ESRD, and manifestations of anti-dsDNA antibody and anti-AnuA antibody in the LN-Ⅲ/Ⅳ patients (with or without LN-Ⅴ) than the LN-Ⅱ/Ⅴ patients (P < 0.05). The cumulative incidence of ESRD was 14.4%, and LN-Ⅲ/Ⅳ(with or without LN-Ⅴ), as well as anti-dsDNA antibody, higher serum creatinine, and SLEDAI ≥10, was identified as independent risk factors for ESRD (OR=2.977, 1.722, 5.484, 2.070). But there was no statistical difference in survival time among different pathological types (P>0.05). Conclusion The LN-Ⅲ/Ⅳ patients (with or without LN-Ⅴ) have higher disease activity, severer impairment both in inside and outside of the kidney, and higher risk of progression to ESRD.

【 授权许可】

Unknown