Michelle Petri1, Erik Barr2, Laurence S Magder2. 1. M. Petri, MD, MPH, Division of Rheumatology, Johns Hopkins University School of Medicine; mpetri@jhmi.edu. 2. E. Barr, MPH, L.S. Magder, MPH, PhD, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Abstract
OBJECTIVE: The frequency of endstage renal disease (ESRD) from systemic lupus erythematosus (SLE) in the United States has not improved over the last few decades in large population datasets. Understanding the risk factors for renal failure in SLE could lead to earlier detection of lupus nephritis and potentially more effective treatments in those with markers of poor prognosis. METHODS: The Hopkins Lupus Cohort, comprising 2528 patients was used. One hundred fifty-one patients experienced renal failure after SLE diagnosis, defined as dialysis or renal transplant. We estimated the risk of renal failure in subgroups defined by demographics, laboratory tests, and the American College of Rheumatology/Systemic Lupus International Collaborating Clinics (ACR/SLICC) classification criteria satisfied within 1 year of SLE diagnosis. RESULTS: The overall incidence of renal failure within 20 years of SLE diagnosis was 8.4%. The risk was much higher (20.0%) among those who experienced proteinuria within the first year of diagnosis. Demographic predictors included African American ethnicity [rate ratio (RR) 1.82, P = 0.0012] and age ≥ 40 years at SLE diagnosis (RR 0.51 vs those with diagnosis at < 30 yrs of age, P = 0.019). Among immunologic markers, low C3 was a strong predictor of renal failure (RR 2.00, P = 0.0011). CONCLUSION: Proteinuria within the first year of diagnosis of SLE is one of the most important predictors of ESRD. Our data also confirm African American ethnicity, younger age at SLE diagnosis, and low C3 as strong predictors of renal failure.
OBJECTIVE: The frequency of endstage renal disease (ESRD) from systemic lupus erythematosus (SLE) in the United States has not improved over the last few decades in large population datasets. Understanding the risk factors for renal failure in SLE could lead to earlier detection of lupus nephritis and potentially more effective treatments in those with markers of poor prognosis. METHODS: The Hopkins Lupus Cohort, comprising 2528 patients was used. One hundred fifty-one patients experienced renal failure after SLE diagnosis, defined as dialysis or renal transplant. We estimated the risk of renal failure in subgroups defined by demographics, laboratory tests, and the American College of Rheumatology/Systemic Lupus International Collaborating Clinics (ACR/SLICC) classification criteria satisfied within 1 year of SLE diagnosis. RESULTS: The overall incidence of renal failure within 20 years of SLE diagnosis was 8.4%. The risk was much higher (20.0%) among those who experienced proteinuria within the first year of diagnosis. Demographic predictors included African American ethnicity [rate ratio (RR) 1.82, P = 0.0012] and age ≥ 40 years at SLE diagnosis (RR 0.51 vs those with diagnosis at < 30 yrs of age, P = 0.019). Among immunologic markers, low C3 was a strong predictor of renal failure (RR 2.00, P = 0.0011). CONCLUSION: Proteinuria within the first year of diagnosis of SLE is one of the most important predictors of ESRD. Our data also confirm African American ethnicity, younger age at SLE diagnosis, and low C3 as strong predictors of renal failure.
Authors: Alfredo Aguirre; Zara Izadi; Laura Trupin; Kamil E Barbour; Kurt J Greenlund; Patti Katz; Cristina Lanata; Lindsey Criswell; Maria Dall'Era; Jinoos Yazdany Journal: Arthritis Care Res (Hoboken) Date: 2022-04-22 Impact factor: 5.178
Authors: Patricia Costa-Reis; Kelly Maurer; Michelle A Petri; Daniella Levy Erez; Xue Zhao; Walter Faig; Jon Burnham; Kathleen O'Neil; Marisa S Klein-Gitelman; Emily von Scheven; Laura Eve Schanberg; Kathleen E Sullivan Journal: Lupus Sci Med Date: 2022-08