Journal article
The frequency and outcome of lupus nephritis: results from an international inception cohort study
Rheumatology (Oxford, England), v 55(2), pp 252-262
01 Feb 2016
PMID: 26342222
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To determine nephritis outcomes in a prospective multi-ethnic/racial SLE inception cohort.
Patients in the Systemic Lupus International Collaborating Clinics inception cohort (≤15 months of SLE diagnosis) were assessed annually for estimated glomerular filtration rate (eGFR), proteinuria and end-stage renal disease (ESRD). Health-related quality of life was measured by the Short Form (36 questions) health survey questionnaire (SF-36) subscales, mental and physical component summary scores.
There were 1827 patients, 89% females, mean (s.d.) age 35.1 (13.3) years. The mean (s.d.) SLE duration at enrolment was 0.5 (0.3) years and follow-up 4.6 (3.4) years. LN occurred in 700 (38.3%) patients: 566/700 (80.9%) at enrolment and 134/700 (19.1%) during follow-up. Patients with nephritis were younger, more frequently men and of African, Asian and Hispanic race/ethnicity. The estimated overall 10-year incidence of ESRD was 4.3% (95% CI: 2.8%, 5.8%), and with nephritis was 10.1% (95% CI: 6.6%, 13.6%). Patients with nephritis had a higher risk of death (HR = 2.98, 95% CI: 1.48, 5.99; P = 0.002) and those with eGFR <30 ml/min at diagnosis had lower SF-36 physical component summary scores (P < 0.01) and lower Physical function, Physical role and Bodily pain scores. Over time, patients with abnormal eGFR and proteinuria had lower SF-36 mental component summary (P ≤ 0.02) scores compared to patients with normal values.
LN occurred in 38.3% of SLE patients, frequently as the initial presentation, in a large multi-ethnic inception cohort. Despite current standard of care, nephritis was associated with ESRD and death, and renal insufficiency was linked to lower health-related quality of life. Further advances are required for the optimal treatment of LN.
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Details
- Title
- The frequency and outcome of lupus nephritis: results from an international inception cohort study
- Creators
- John G Hanly - Queen Elizabeth II Health Sciences CentreAidan G O'Keeffe - Department of Statistical Science, University College London, LondonLi Su - MRC Biostatistics UnitMurray B Urowitz - Toronto Western HospitalJuanita Romero-Diaz - Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránCaroline Gordon - University of BirminghamSang-Cheol Bae - Hanyang University Seoul HospitalSasha Bernatsky - McGill University Health CentreAnn E Clarke - University of CalgaryDaniel J Wallace - Cedars-Sinai Medical CenterJoan T Merrill - Oklahoma Medical Research FoundationDavid A Isenberg - University College LondonAnisur Rahman - University College LondonEllen M Ginzler - SUNY Downstate Health Sciences UniversityPaul Fortin - Université LavalDafna D Gladman - Toronto Western HospitalJorge Sanchez-Guerrero - Toronto Western HospitalMichelle Petri - Johns Hopkins MedicineIan N Bruce - Manchester Academic Health Science CentreMary Anne Dooley - University of North Carolina at Chapel HillRosalind Ramsey-Goldman - Northwestern UniversityCynthia Aranow - Feinstein Institute for Medical ResearchGraciela S Alarcón - University of Alabama at BirminghamBarri J Fessler - University of Alabama at BirminghamKristjan Steinsson - Reykjavík UniversityOla Nived - Lund UniversityGunnar K Sturfelt - Lund UniversitySusan Manzi - University of PittsburghMunther A Khamashta - St Thomas' HospitalRonald F van Vollenhoven - Karolinska InstitutetAsad A Zoma - Hairmyres HospitalManuel Ramos-Casals - Consorci Institut D'Investigacions Biomediques August Pi I SunyerGuillermo Ruiz-Irastorza - University of the Basque CountryS Sam Lim - Emory UniversityThomas Stoll - Spitäler SchaffhausenMurat Inanc - Istanbul UniversityKenneth C Kalunian - University of California, San DiegoDiane L Kamen - Medical University of South CarolinaPeter Maddison - Ysbyty Gwynedd Hospital NHS TrustChristine A Peschken - University of ManitobaSoren Jacobsen - Copenhagen University HospitalAnca Askanase - New York University Langone Orthopedic HospitalChris Theriault - Queen Elizabeth II Health Sciences CentreKara Thompson - Queen Elizabeth II Health Sciences CentreVernon Farewell - MRC Biostatistics Unit
- Publication Details
- Rheumatology (Oxford, England), v 55(2), pp 252-262
- Publisher
- Oxford University Press
- Grant note
- R01 AR043727 / NIAMS NIH HHS AR43727 / NIAMS NIH HHS UL1 TR001422 / NCATS NIH HHS MC_U105261167 / Medical Research Council
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000370205200010
- Scopus ID
- 2-s2.0-84961872402
- Other Identifier
- 991021934007504721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Rheumatology