Jiahuan Ge1, Ziyi Jin2, Xuebing Feng3, Wenyou Pan4, Lin Liu5, Min Wu6, Huaixia Hu7, Xiang Ding8, Hua Wei9, Yaohong Zou10, Xian Qian11, Meimei Wang12, Jian Wu13, Juan Tao14, Jun Tan15, Zhanyun Da16, Miaojia Zhang17, Jing Li18, Lingyun Sun19,20. 1. Nanjing Drum Tower Hospital Clinical College, Nanjing Medical University, Nanjing, China. 2. Department of Rheumatology and Immunology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, China. jzy-327@163.com. 3. Department of Rheumatology and Immunology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, China. 4. Department of Rheumatology, Huai'an First People's Hospital, Huai'an, China. 5. Department of Rheumatology, Xuzhou Central Hospital, Xuzhou, China. 6. Department of Rheumatology, The Third Affiliated Hospital of Soochow University, Changzhou, China. 7. Department of Rheumatology, Lianyungang Second People's Hospital, Lianyungang, China. 8. Department of Rheumatology, Lianyungang First People's Hospital, Lianyungang, China. 9. Department of Rheumatology, Northern Jiangsu People's Hospital, Yangzhou, China. 10. Department of Rheumatology, Wuxi People's Hospital, Wuxi, China. 11. Department of Rheumatology, Jiangsu Province Hospital of TCM, Nanjing, China. 12. Department of Rheumatology, Southeast University Zhongda Hospital, Nanjing, China. 13. Department of Rheumatology, The First Affiliated Hospital of Soochow University, Suzhou, China. 14. Department of Rheumatology, Wuxi TCM Hospital, Wuxi, China. 15. Department of Rheumatology, Zhenjiang First People's Hospital, Zhenjiang, China. 16. Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, China. 17. Department of Rheumatology, Jiangsu Province Hospital, Nanjing, China. 18. Department of Rheumatology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China. 19. Nanjing Drum Tower Hospital Clinical College, Nanjing Medical University, Nanjing, China. lingyunsun@nju.edu.cn. 20. Department of Rheumatology and Immunology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, China. lingyunsun@nju.edu.cn.
Abstract
OBJECTIVE: To explore the association between the creatinine clearance rate (Ccr) and the prognosis of patients, and compared with estimated glomerular filtration rate (eGFR). METHODS: We retrospectively collected information of patients with SLE who were first hospitalized between 1999 and 2009 in Jiangsu Province, China, and followed up in 2010 and 2015. Ccr was calculated and dichotomized into normal group (Ccr ≥ 70) and decreasing group (Ccr < 70). The clinical characteristics of the two groups were compared and Cox proportional-hazards regression models were used to calculate hazard ratio (HR) and 95% confidence interval (CI). RESULTS: Among 1990 SLE patients, we observed 437 (22.0%) with decreased Ccr, including 237 cases (11.9%) with mild renal dysfunction, 136 cases (6.8%) with moderate renal dysfunction, and 64 cases (3.2%) with severe renal dysfunction. Compared to normal Ccr, decreasing Ccr had a higher risk for mortality with adjusted HR (95% CI) of 2.21 (1.59-3.06). Dose-response relationships were significantly found between increased mortality of SLE and decreased Ccr (p for trend < 0. 001), as well as eGFR. Positive associations were consistently observed in subgroups, such as systemic lupus disease activity index (SLEDAI) ≥ 15, without comorbidities and abnormal laboratory indexes. Decreasing Ccr was positively associated with mortality from infection and renal failure with HR (95% CI) of 1.80 (1.02-3.19) and 6.84 (3.05-15.36). CONCLUSIONS: A significant association has been observed between decreased Ccr and increased risk for mortality of SLE patients. Early clinical interventions to modulate the Ccr of SLE patients may be beneficial to their survival. Key points • Decreasing creatinine clearance rate (Ccr) was positively associated with an overall mortality of SLE patients, with a dose-response relationship. • Moreover, decreasing Ccr was associated with elevated mortality primarily due to infection and renal failure.
OBJECTIVE: To explore the association between the creatinine clearance rate (Ccr) and the prognosis of patients, and compared with estimated glomerular filtration rate (eGFR). METHODS: We retrospectively collected information of patients with SLE who were first hospitalized between 1999 and 2009 in Jiangsu Province, China, and followed up in 2010 and 2015. Ccr was calculated and dichotomized into normal group (Ccr ≥ 70) and decreasing group (Ccr < 70). The clinical characteristics of the two groups were compared and Cox proportional-hazards regression models were used to calculate hazard ratio (HR) and 95% confidence interval (CI). RESULTS: Among 1990 SLEpatients, we observed 437 (22.0%) with decreased Ccr, including 237 cases (11.9%) with mild renal dysfunction, 136 cases (6.8%) with moderate renal dysfunction, and 64 cases (3.2%) with severe renal dysfunction. Compared to normal Ccr, decreasing Ccr had a higher risk for mortality with adjusted HR (95% CI) of 2.21 (1.59-3.06). Dose-response relationships were significantly found between increased mortality of SLE and decreased Ccr (p for trend < 0. 001), as well as eGFR. Positive associations were consistently observed in subgroups, such as systemic lupus disease activity index (SLEDAI) ≥ 15, without comorbidities and abnormal laboratory indexes. Decreasing Ccr was positively associated with mortality from infection and renal failure with HR (95% CI) of 1.80 (1.02-3.19) and 6.84 (3.05-15.36). CONCLUSIONS: A significant association has been observed between decreased Ccr and increased risk for mortality of SLEpatients. Early clinical interventions to modulate the Ccr of SLEpatients may be beneficial to their survival. Key points • Decreasing creatinine clearance rate (Ccr) was positively associated with an overall mortality of SLEpatients, with a dose-response relationship. • Moreover, decreasing Ccr was associated with elevated mortality primarily due to infection and renal failure.
Authors: Z Wang; M Li; Y Wang; D Xu; Q Wang; S Zhang; J Zhao; J Su; Q Wu; Q Shi; X Leng; W Zhang; X Tian; Y Zhao; X Zeng Journal: Lupus Date: 2018-01-07 Impact factor: 2.911
Authors: D D Gladman; M B Urowitz; C H Goldsmith; P Fortin; E Ginzler; C Gordon; J G Hanly; D A Isenberg; K Kalunian; O Nived; M Petri; J Sanchez-Guerrero; M Snaith; G Sturfelt Journal: Arthritis Rheum Date: 1997-05
Authors: Pedro Serrano-Aguilar; Maria del Mar Trujillo-Martin; Abraham Pérez de la Rosa; Leticia Cuellar-Pompa; Hugo Saavedra-Medina; Renata Linertova; Lilisbeth Perestelo-Perez; Jeanette Perez-Ramos; Amado Rivero-Santana Journal: Patient Educ Couns Date: 2015-06-11