Shingo Ishimori1,2, Hiroshi Kaito1, Yuko Shima3, Ichiro Kamioka2, Kiyoshi Hamahira4, Kandai Nozu1, Koichi Nakanishi5, Ryojiro Tanaka6, Norishige Yoshikawa7, Kazumoto Iijima1. 1. Department of Pediatrics, Kobe University Graduate School of Medicine, Hyogo, Japan. 2. Department of Pediatrics, Kakogawa Central City Hospital, Hyogo, Japan. 3. Department of Pediatrics, Wakayama Medical University, Wakayama, Japan. 4. Department of Pediatrics, Himeji Red-Cross Hospital, Hyogo, Japan. 5. Department of Pediatrics, Ryukyu University Graduate School of Medicine, Okinawa, Japan. 6. Department of Nephrology, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan. 7. Clinical Research Center, Wakayama Medical University, Wakayama, Japan.
Abstract
Objectives: Acute kidney injury (AKI) at onset of adult systemic lupus erythematosus (SLE) is a risk factor for end stage kidney disease (ESKD). However, data on childhood-onset lupus nephritis (LN) with AKI are scarce. Methods: We retrospectively reviewed the complete files of pediatric SLE patients from 1995 to 2010. All patients underwent kidney biopsy promptly after diagnosis. Results: Thirty-six patients (10 males and 26 females) were enrolled. Mean age at diagnosis and observation period were 11.6 ± 2.4 and 8.1 ± 4.4 years, respectively. Seven patients had AKI at onset of SLE. Compared with those without AKI, patients with AKI had significantly higher proportions of pathologically proliferative LN. Only one patient with AKI progressed to ESKD without complete recovery of renal function. Overall and renal survival rates were 100and 97.2%, respectively. There was no significant difference in estimated glomerular filtration rate at the final visit (85ml/min/1.73 m2 in the AKI group vs. 103.2 ml/min/1.73 m2 in the non-AKI group; p = .11). Conclusion: Our study demonstrated favorable renal outcomes in childhood-onset LN with AKI in the near to midterm period. Inducing complete remission may be important for preserving renal function.
Objectives:Acute kidney injury (AKI) at onset of adult systemic lupus erythematosus (SLE) is a risk factor for end stage kidney disease (ESKD). However, data on childhood-onset lupus nephritis (LN) with AKI are scarce. Methods: We retrospectively reviewed the complete files of pediatric SLEpatients from 1995 to 2010. All patients underwent kidney biopsy promptly after diagnosis. Results: Thirty-six patients (10 males and 26 females) were enrolled. Mean age at diagnosis and observation period were 11.6 ± 2.4 and 8.1 ± 4.4 years, respectively. Seven patients had AKI at onset of SLE. Compared with those without AKI, patients with AKI had significantly higher proportions of pathologically proliferative LN. Only one patient with AKI progressed to ESKD without complete recovery of renal function. Overall and renal survival rates were 100and 97.2%, respectively. There was no significant difference in estimated glomerular filtration rate at the final visit (85ml/min/1.73 m2 in the AKI group vs. 103.2 ml/min/1.73 m2 in the non-AKI group; p = .11). Conclusion: Our study demonstrated favorable renal outcomes in childhood-onset LN with AKI in the near to midterm period. Inducing complete remission may be important for preserving renal function.
Authors: Brian R Stotter; Ellen Cody; Hongjie Gu; Ankana Daga; Larry A Greenbaum; Minh Dien Duong; Alexandra Mazo; Beatrice Goilav; Alexis Boneparth; Mahmoud Kallash; Ahmed Zeid; Wacharee Seeherunvong; Rebecca R Scobell; Issa Alhamoud; Caitlin E Carter; Siddharth Shah; Caroline E Straatmann; Bradley P Dixon; Jennifer C Cooper; Raoul D Nelson; Deborah M Levy; Hermine I Brunner; Priya S Verghese; Scott E Wenderfer Journal: Pediatr Nephrol Date: 2022-10-17 Impact factor: 3.651