Liu Chao-Han, Kor Chew-Teng, Hsiao Kai-Hung, Tien Ya-Chih
Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Changhua Christian Hospital, 135 Nanxiao Street, Changhua City, 500-06, Taiwan.
Big Data Center, Changhua Christian Hospital, Changhua, Taiwan.
Clin Rheumatol. 2025 Sep 2. doi: 10.1007/s10067-025-07618-2.
To investigate the long-term outcome of patients with systemic lupus erythematosus (SLE) who presented with renal involvement in a Taiwanese population.
Data of patients diagnosed with SLE at Changhua Christian Hospital Clinical Research Database from January 2010 until December 2021 were retrospectively reviewed. Participants were categorized according to the presence of renal involvement, defined as a high protein-to-creatinine ratio or positive histopathology of kidney biopsy. Incidence rates and risk factors of chronic kidney disease (CKD) and end-stage renal disease (ESRD) were analyzed.
A total of 2184 eligible patients with SLE were enrolled, of which 293 had renal involvement. The risk of CKD/ESRD development was higher among participants with renal involvement compared with those without renal involvement. The median times to development of CKD and ESRD were 2.03 years (IQR: 0.13-6.33) and 7.34 years (IQR: 3.13-10.41), respectively, among renal involvement participants. The cumulative incidence rates of CKD were 46.6%, 54.5%, and 63% at 1, 2, and 5 years after renal involvement, respectively, and those of ESRD were 4%, 7%, and 11%, respectively. In the subgroups of two definitions (PCR- or biopsy-defined renal involvement) for renal involvement, the incidence rate of developing CKD/ESRD was not significantly different between the groups. Multivariate analysis revealed that factors associated with CKD development were renal involvement, age, hypertension, and serositis.
Among the Taiwanese population, compared with patients without renal involvement, patients with renal involvement were at a higher risk of developing CKD, and the 5-year incidence rate of ESRD is 11% in this study. Key Points • Among the patients with systemic lupus erythematosus in the Taiwanese population, patients with renal involvement were at a higher risk of developing CKD and ESRD. • The median times-to-development of CKD and ESRD were 2.03 (IQR: 0.13-6.33) years and 7.34 (IQR: 3.13-10.41) years, respectively, among renal involvement participants, whilst the cumulative incidence rates of CKD and ESRD at 5 years after renal involvement were 63% and 11%, respectively. • Subgroup analyses to investigate patients with PCR- and biopsy-defined renal involvement were additionally performed in this study, revealing similar incidence rates of CKD and ESRD in both subgroups.
探讨台湾地区系统性红斑狼疮（SLE）合并肾脏受累患者的长期预后。
回顾性分析2010年1月至2021年12月在彰化基督教医院临床研究数据库中诊断为SLE的患者数据。根据是否存在肾脏受累对参与者进行分类，肾脏受累定义为高蛋白肌酐比或肾活检组织病理学阳性。分析慢性肾脏病（CKD）和终末期肾病（ESRD）的发病率及危险因素。
共纳入2184例符合条件的SLE患者，其中293例有肾脏受累。与无肾脏受累的参与者相比，有肾脏受累的参与者发生CKD/ESRD的风险更高。在有肾脏受累的参与者中，发生CKD和ESRD的中位时间分别为2.03年（四分位间距：0.13 - 6.33）和7.34年（四分位间距：3.13 - 10.41）。肾脏受累后1年、2年和5年的CKD累积发病率分别为46.6%、54.5%和63%，ESRD的累积发病率分别为4%、7%和11%。在肾脏受累的两种定义（PCR或活检定义的肾脏受累）亚组中，两组发生CKD/ESRD的发病率无显著差异。多因素分析显示，与CKD发生相关的因素有肾脏受累、年龄、高血压和浆膜炎。
在台湾地区人群中，与无肾脏受累的患者相比，有肾脏受累的患者发生CKD的风险更高，本研究中ESRD的5年发病率为11%。要点•在台湾地区系统性红斑狼疮患者中，有肾脏受累的患者发生CKD和ESRD的风险更高。•在有肾脏受累的参与者中，发生CKD和ESRD的中位时间分别为2.03（四分位间距：0.13 - 6.33）年和7.34（四分位间距：3.13 - 10.41）年，而肾脏受累后5年的CKD和ESRD累积发病率分别为63%和11%。•本研究还对PCR和活检定义的肾脏受累患者进行了亚组分析，显示两个亚组中CKD和ESRD的发病率相似。
