Time to recovery from Proteinuria and its related factors in patients with lupus nephritis
objective: lupus nephritis (LN) is a severe form of systemic lupus erythematosus (SLE) with renal involvement. It affects the kidneys in about 50% of SLE patients. The aim of this study was to assess the evaluation of proteinuria recovery time and its related factors associated with lupus nephritis patients in Urmia- Northwest of Iran.
Methods: A retrospective cohort study was carried out, in which medical records of 80 patients with systemic lupus nephritis referred to Imam Khomeini university hospital were reviewed. According to these records biopsy-proven renal disease has been progressed from September 2009 to September 2013. Proteinuria less than 0.5 g/24h was defined as proteinuria recovery. The time elapsed from the diagnosis of proteinuria to its recovery is considered as the duration of proteinuria recovery (month). The findings were analyzed by STATA11 statistical software.
Results: Mean age at diagnosis of lupus nephritis was 26.50±8.10 years (14-51 years). Mean creatinine level at the start of treatment was 1.20±0.61 mg/dl (0.5- 2.80). Proteinuria recovery time was 4 months for 25% of patients, 6 months for 50% of patients (median time) and 12 months for 75% of them. Higher class of LN had a trend toward 31 % lower risk of proteinuria recovery (HR: 0.73, 95% CI 0.56 -0.96; P= 0.02), the expected risk is 1.94 times greater in women as compared with men (HR: 1.94, 95% CI 1.1-3.48; P=0.02).
Conclusions: The patients in this study population respond to treatment in less time and in comparison with other studies, their proteinuria recovers earlier. Class of lupus nephritis (negative) and gender (positive) were predictive factors proteinuria recovery among LN patients.
2. Nezhad ST, Sepaskhah R. Correlation of clinical and pathological findings in patients with lupus nephritis: a five-year experience in Iran. Saudi J Kidney Dis Transpl 2008;19:32-40.
3. Almaani S, Meara A, Rovin BH. Update on lupus nephritis. Clin J Am Soc Nephrol 2017;12:825-35.
4. Saadati N, Hami M, Aghdam AB, Naghibzadeh B. Relational Study of Clinical Findings and Renal Pathology in Systemic Lupus Erythematosus Patients. Med J Mashhad Univ Med Sci 2013;55:218-24.
5. Ichinose K, Kitamura M, Sato S, Eguchi M, Okamoto M, Endo Y, et al. Complete renal response at 12 months after induction therapy is associated with renal relapse-free rate in lupus nephritis: a single-center, retrospective cohort study. Lupus 2019;28:501-9.
6. Davidson JE, Fu Q, Ji B, Rao S, Roth D, Magder LS, et al. Renal Remission Status and Longterm Renal Survival in Patients with Lupus Nephritis: A Retrospective Cohort Analysis. J Rheumatol 2018;45:671-7.
7. Obrișcă B, Jurubiță R, Andronesi A, Sorohan B, Achim C, Bobeica R, et al. Histological predictors of renal outcome in lupus nephritis: the importance of tubulointerstitial lesions and scoring of glomerular lesions. Lupus 2018;27:1455-63.
8. Touma Z, Urowitz MB, Ibañez D, Gladman DD. Time to Recovery from Proteinuria in Patients with Lupus Nephritis Receiving Standard Treatment. J Rheumatol 2014;41:688-97.
9. Fung WA, Su J, Touma Z. Predictors of Good Long-Term Renal Outcomes in Lupus Nephritis: Results from a Single Lupus Cohort. Biomed Res Int 2017;2017:5312960.
10. Soleymani Salehabadi H, Bashiri H, Nouri Majelan N, Dehghan A, Owlia M. Prognostic factors of lupus nephritis in an Iranian population. Rheumatol Res 2017;2:17-22.
11. Tamirou F, Lauwerys BR, Dall'Era M, Mackay M, Rovin B, Cervera R, et al. A proteinuria cut-off level of 0.7 g/day after 12 months of treatment best predicts long-term renal outcome in lupus nephritis: data from the MAINTAIN Nephritis Trial. Lupus Sci Med 2015;2:e000123.
12. Akbarian M, Faezi ST, Gharibdoost F, Shahram F, Nadji A, Jamshidi AR, et al. Systemic lupus erythematosus in Iran: a study of 2280 patients over 33 years. Int J Rheum Dis 2010;13:374-9.
13. Pinto-Peñaranda LF, Duque-Caballero V, Márquez-Hernández JD, Muñoz-Grajales C, Velásquez-Franco CJ. Predictive factors for low rate of remission in a population of Colombian patients with severe proliferative lupus nephritis. Clin Rheumatol 2015;34:897-903.
14. Miranda-Hernández D, Cruz-Reyes C, Angeles U, Jara LJ, Saavedra MA. Prognostic factors for treatment response in patients with lupus nephritis. Reumatol Clin. 2014;10:164-9.
15. Chen YE, Korbet SM, Katz RS, Schwartz MM, Lewis EJ; Collaborative Study Group. Value of a complete or partial remission in severe lupus nephritis. Clin J Am Soc Nephrol 2008;3:46-53.
16. Korbet SM, Lewis EJ. Complete remission in severe lupus nephritis: assessing the rate of loss in proteinuria. Nephrol Dial Transplant 2012;27:2813-9.
17. Lusco MA, Fogo AB, Najafian B, Alpers CE3. AJKD Atlas of Renal Pathology: Membranous Lupus Nephritis, ISN/RPS Class V. Am J Kidney Dis 2017;70:e13-5.
|Issue||Vol 59, No 9 (2021)|
|lupus nephritis proteinuria recovery time predictive factors Urmia|
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