Kosałka-Węgiel Joanna, Dziedzic Radosław, Siwiec-Koźlik Andżelika, Spałkowska Magdalena, Milewski Mamert, Wach Anita, Zaręba Lech, Bazan-Socha Stanisława, Korkosz Mariusz
Jagiellonian University Medical College, Department of Rheumatology and Immunology, Jakubowskiego 2, 30-688 Kraków, Poland.
University Hospital, Department of Rheumatology, Immunology and Internal Medicine, Jakubowskiego 2, 30-688 Kraków, Poland.
J Clin Med. 2024 Jul 31;13(15):4486. doi: 10.3390/jcm13154486.
: Lupus nephritis (LN) is an inflammation of the kidneys that is related to systemic lupus erythematosus (SLE). This study aimed to evaluate the differences in clinical and laboratory characteristics between LN and non-LN SLE patients. : We conducted a retrospective analysis of medical records collected from SLE patients treated at the University Hospital in Kraków, Poland, from 2012 to 2022. All patients met the 2019 European League Against Rheumatism and the American College of Rheumatology (EULAR/ACR) criteria for SLE. : Among 921 SLE patients, LN was documented in 331 (35.94%). LN patients were younger at SLE diagnosis (29 vs. 37 years; < 0.001) and had a male proportion that was 2.09 times higher than the non-LN group (16.62% vs. 7.97%; < 0.001). They were more often diagnosed with serositis and hematological or neurological involvement ( < 0.001 for all). Hypertension and hypercholesterolemia occurred more frequently in these patients ( < 0.001 for both). LN patients exhibited a higher frequency of anti-dsDNA, anti-histone, and anti-nucleosome antibodies ( < 0.001 for all). Conversely, the non-LN group had a 1.24-fold (95% CI: 1.03-1.50; = 0.021) increase in the odds ratio of having positive anti-cardiolipin IgM antibody results. LN patients were more frequently treated with immunosuppressants. The risk factors for experiencing at least three LN flares included female sex, younger age at the onset of LN or SLE, LN occurring later than SLE onset, the presence of anti-nucleosome or anti-dsDNA antibodies, and certain SLE manifestations such as myalgia, arthritis, proteinuria > 3.5 g/day, and pathological urinary casts in the urine sediment. : LN patients differ from non-LN patients in the age of SLE diagnosis, treatment modalities, and autoantibody profile and have more frequent, severe manifestations of SLE. However, we still need more prospective studies to understand the diversity of LN and its progression in SLE patients.
狼疮性肾炎（LN）是一种与系统性红斑狼疮（SLE）相关的肾脏炎症。本研究旨在评估LN患者与非LN的SLE患者在临床和实验室特征方面的差异。
我们对2012年至2022年在波兰克拉科夫大学医院接受治疗的SLE患者的病历进行了回顾性分析。所有患者均符合2019年欧洲抗风湿病联盟和美国风湿病学会（EULAR/ACR）的SLE诊断标准。
在921例SLE患者中，有331例（35.94%）记录有LN。LN患者在SLE诊断时年龄较小（29岁对37岁；<0.001），男性比例是非LN组的2.09倍（16.62%对7.97%；<0.001）。他们更常被诊断为浆膜炎以及血液系统或神经系统受累（所有P<0.001）。这些患者中高血压和高胆固醇血症的发生率更高（两者P<0.001）。LN患者抗双链DNA、抗组蛋白和抗核小体抗体的出现频率更高（所有P<0.001）。相反，非LN组抗心磷脂IgM抗体检测结果呈阳性的比值比增加了1.24倍（95%CI：1.03 - 1.50；P = 0.021）。LN患者更常接受免疫抑制剂治疗。经历至少三次LN病情复发的危险因素包括女性、LN或SLE发病时年龄较小、LN发病晚于SLE、存在抗核小体或抗双链DNA抗体以及某些SLE表现，如肌痛、关节炎、蛋白尿>3.5g/天和尿沉渣中出现病理性管型。
LN患者与非LN患者在SLE诊断年龄、治疗方式和自身抗体谱方面存在差异，且SLE表现更频繁、更严重。然而，我们仍需要更多前瞻性研究来了解LN的多样性及其在SLE患者中的进展情况。
