Department of Nephrology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
NHC Key Laboratory of Clinical Nephrology (Sun Yat-Sen University) and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China.
Nephron. 2023;147(7):408-416. doi: 10.1159/000528486. Epub 2023 Jan 19.
The aim of this study was to evaluate the association of peripheral eosinophil (EOS) count with disease activity and kidney outcomes in lupus nephritis (LN) patients.
A total of 453 hospitalized and biopsy-proven LN patients at our hospital from 2006 to 2013 were enrolled, of which 388 patients had repeated measurements of EOS. Relationships were explored between average EOS and disease activity at baseline, using the systemic lupus erythematosus disease activity (SLEDAI) and activity index (AI) on kidney biopsy. Follow-up data were available through December 2016. The primary outcome measure was a composite of doubling of serum creatinine and end-stage kidney disease after a median follow-up of 51 months.
The mean age of the enrolled 388 LN patients was 33.1 ± 10.8 years old, and 335 (86%) were female. The median average peripheral EOS count was 0.033 (0.015-0.057) ×109/L. Mean AI and SLEDAI score were 6.8 ± 2.5 and 14.9 ± 5.4, respectively. Logistic regression models showed that decreased average EOS was independently associated with higher AI (≥6) and higher SLEDAI (≥15) (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.90-0.97; and OR 0.96, 95% CI: 0.93-0.99, respectively). There was a parabolic relationship between average EOS and the primary outcome, with hazard ratio (HR) > 1 for both levels ≤0.033 and >0.16 × 109/L.
Lower EOS count was independently associated with severe disease activity and kidney progression in LN.
本研究旨在评估外周血嗜酸性粒细胞（EOS）计数与狼疮肾炎（LN）患者疾病活动度和肾脏结局的相关性。
共纳入 2006 年至 2013 年我院收治的 453 例住院并经肾活检证实的 LN 患者，其中 388 例患者重复测量了 EOS。使用系统性红斑狼疮疾病活动度（SLEDAI）和肾活检活动指数（AI）评估基线时平均 EOS 与疾病活动度的关系。截至 2016 年 12 月，可获得随访数据。主要观察终点为中位随访 51 个月后血清肌酐加倍和终末期肾病的复合终点。
纳入的 388 例 LN 患者的平均年龄为 33.1 ± 10.8 岁，335 例（86%）为女性。外周血 EOS 计数的中位数为 0.033（0.015-0.057）×109/L。平均 AI 和 SLEDAI 评分分别为 6.8 ± 2.5 和 14.9 ± 5.4。Logistic 回归模型显示，EOS 计数降低与 AI（≥6）和 SLEDAI（≥15）升高独立相关（比值比 [OR] 0.93，95%置信区间 [CI] 0.90-0.97；OR 0.96，95%CI：0.93-0.99）。EOS 计数与主要结局之间呈抛物线关系，EOS 计数≤0.033 和＞0.16×109/L 时 HR 均大于 1。
EOS 计数降低与 LN 患者严重疾病活动度和肾脏进展独立相关。
