Tonsawan Pantipa, Sawanyawisuth Kittisak
Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
Auto Immun Highlights. 2020 Dec 2;11(1):18. doi: 10.1186/s13317-020-00140-2.
Lupus nephritis is a type of major organ involvement in systemic lupus erythematosus (SLE) patients that leads to higher rates of morbidity and mortality and may present initially in 28% of SLE patients. However, there are limited data available on clinical differences or predictors for biopsy-proven lupus nephritis in established versus newly diagnosed SLE cases.
Adult patients undergoing kidney biopsy for the first time with a diagnosis of lupus nephritis were eligible for inclusion. Patients were categorized into two groups: those with previously diagnosed SLE and those with newly diagnosed SLE by kidney biopsy. Factors associated with newly diagnosed SLE were determined using logistic regression analysis.
There were 68 patients diagnosed with lupus nephritis by kidney biopsy. Of those, 31 cases (45.58%) were newly diagnosed. The newly diagnosed SLE group was significantly older (36.87 vs 30.95 years) and had a lower proportion of females (74.19% vs 91.89%) than the previously diagnosed group. A new-onset hypertension was the only factor independently associated with newly diagnosed SLE by kidney biopsy. The adjusted odds ratio (95% CI) was 5.152 (1.046, 25.363).
Nearly half of the biopsy-proven lupus nephritis cases in this study were patients with newly diagnosed SLE. Patients with previously diagnosed SLE and newly diagnosed SLE by kidney biopsy had clinical differences.
狼疮性肾炎是系统性红斑狼疮(SLE)患者主要器官受累的一种类型,其导致更高的发病率和死亡率,并且可能在28%的SLE患者中首次出现。然而,关于确诊的SLE病例与新诊断的SLE病例中经活检证实的狼疮性肾炎的临床差异或预测因素的数据有限。
首次接受肾活检且诊断为狼疮性肾炎的成年患者符合纳入标准。患者被分为两组:经肾活检先前已诊断为SLE的患者和新诊断为SLE的患者。使用逻辑回归分析确定与新诊断的SLE相关的因素。
有68例患者经肾活检诊断为狼疮性肾炎。其中,31例(45.58%)为新诊断病例。与先前诊断的组相比,新诊断的SLE组年龄显著更大(36.87岁对30.95岁),女性比例更低(74.19%对91.89%)。新发高血压是经肾活检与新诊断的SLE独立相关的唯一因素。调整后的优势比(95%可信区间)为5.152(1.046,25.363)。
本研究中近一半经活检证实的狼疮性肾炎病例为新诊断的SLE患者。经肾活检先前已诊断为SLE的患者和新诊断为SLE的患者存在临床差异。