Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Nephrology, Nagasaki University Hospital, Nagasaki, Japan.
Clin Immunol. 2018 Dec;197:161-168. doi: 10.1016/j.clim.2018.10.002. Epub 2018 Oct 5.
Morphological change that includes diffuse effacement of podocyte foot processes is correlated with proteinuria in patients with lupus nephritis (LN). We collected the data of clinico-pathological parameters and assessed foot process width (FPW) as an index of podocyte effacement in 73 patients with LN who had undergone renal biopsy. The multivariate analysis revealed that female gender (OR: 5.288; 95%CI: 1.197-37.29; p = .0267) and FPW (OR = 0.999, 95%CI = 0.997-0.999, p = .0150) were significantly predictive of a complete renal response (CR) at 6 months, while lymphocyte counts (OR = 1.002; 95%CI = 1.001-1.003, p = .0028) and FPW (OR = 0.998, 95%CI = 0.996-0.999, p = .0027) were significantly predictive of CR at 12 months. The cut-off point determined by the Classification and Regression Trees algorithm showed that FPW <908.3 nm provides the best performance for predicting patients who achieve CR at 12 months. A smaller FPW appears to be a predictive factor for CR at 6 and 12 months after induction therapy.
形态学改变包括足细胞足突弥漫性消失与狼疮肾炎（LN）患者的蛋白尿相关。我们收集了临床病理参数的数据，并评估了 73 例接受肾活检的 LN 患者的足突宽度（FPW）作为足细胞消失的指标。多因素分析显示，女性（OR：5.288；95%CI：1.197-37.29；p=0.0267）和 FPW（OR=0.999，95%CI=0.997-0.999，p=0.0150）是 6 个月完全缓解（CR）的显著预测因素，而淋巴细胞计数（OR=1.002；95%CI=1.001-1.003，p=0.0028）和 FPW（OR=0.998，95%CI=0.996-0.999，p=0.0027）是 12 个月 CR 的显著预测因素。分类回归树算法确定的截断值表明，FPW<908.3nm 对预测 12 个月时达到 CR 的患者具有最佳性能。较小的 FPW 似乎是诱导治疗后 6 个月和 12 个月达到 CR 的预测因素。
