A retrospective study on the risk factors and time distribution of renal recurrence in lupus nephritis patients with long-term follow-up
10.3760/cma.j.cn441217-20210823-00055
- VernacularTitle:狼疮肾炎患者肾脏复发的风险因素及时间分布的长期随访研究
- Author:
Jingjing WANG
1
;
Chenfeng JIAO
;
Zhengzhao LIU
;
Fan YANG
;
Haitao ZHANG
Author Information
1. 南京大学医学院附属金陵医院（东部战区总医院）肾内科 国家肾脏疾病临床医学研究中心 全军肾脏病研究所，南京 210016
- Keywords:
Lupus nephritis;
Pathology, clinical;
Recurrence;
Risk factors
- From:
Chinese Journal of Nephrology
2022;38(5):379-386
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors and time distribution of renal relapse in patients with lupus nephritis (LN).Methods:Clinical, pathological characteristics and long-term outcomes of LN patients who were diagnosed and followed in Jinling Hospital from January 2004 to December 2008 were retrospectively analyzed. The patients were divided into relapse group and non-relapse group. The differences of clinical pathological characteristics between the two groups were compared. The multivariate Cox proportion risk model was used to analyze the risk factors affecting renal relapse in LN. The risk factors and time distribution of renal relapse were analyzed with annual relapse risk-time curve.Results:A total of 814 patients with LN were included in the study, with 419 cases (51.5%) of complete remission and 395 cases (48.5%) of partial remission. The age was (30.24±10.90) years old, and there were 112 males (13.8%). There were 367 patients suffering renal relapse. The time of first renal relapse was (3.21±2.70) years. The results of multivariate Cox regression showed that age ( HR=0.976, 95% CI 0.966-0.986, P<0.001), renal pathological activity index (AI) score ( HR=1.039, 95% CI 1.013-1.065, P=0.003), remission status after induction treatment ( HR=0.671, 95% CI 0.504-0.894, P=0.006), 24 h urinary protein quantitation ( HR=1.297, 95% CI 1.115-1.508, P=0.001), anti-double strand DNA antibody (A-dsDNA, HR=1.450, 95% CI 1.139-1.846, P=0.003) and complement C3 ( HR=0.223, 95% CI 0.128-0.389, P<0.001) were correlated with increasing risk of renal relapse in LN. The annual relapse risk profile was unimodal, with a peak period of the second year after maintenance treatment. Similar patterns of relapse were presented in subgroup analysis. Conclusions:Age, renal pathological AI score, remission status after induction therapy, 24 h urine protein, A-dsDNA and blood complement C3 are the influencing factors for relapse of LN patients. The peak period of renal relapse in patients with LN is in the second year of maintenance therapy.
