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Clinicopathological and outcome analysis of adult lupus nephritis patients in China

  • Nephrology - Original Paper
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Abstract

Background

The objective of this study was to assess clinicopathological characteristics and outcomes of lupus nephritis adult patients in China.

Methods

Clinicopathological features, treatment strategies, responses and outcome of 681 adult patients with biopsy-proved lupus nephritis were retrospectively analyzed.

Results

Six hundred and eighty-one LN patients were included and followed up for 52.5 ± 14.1 months. Differences in age, disease duration, BP, proteinuria, serum albumin, creatinine, ANCA-positive ratio and SLEDAI scores were noticed between male and female patients, indicating severer disease in male patients. LN IV patients were much severer in systemic damage as well as immunological changes. During follow-up, 354 patients achieved CR, 107 patients achieved PR, 95 patients progressed to ESRD and 36 patients died. Prognosis and treatment response of patients with different histological types differ apparently. Renal outcome of patients with LN II and III was benign, while LN IV, V and VI was poor. Cyclophosphamide was effective in most patients. MMF and CNI could be used as salvage treatment. In multivariate analysis, BP, sCr, hypocomplementemia, severe proliferative lesion (LN IV or VI) and SLEDAI score were recognized as independent indicators of poor renal outcome. Infections, especially pulmonary fungus infection, thrombotic microangiopathy are the most common causes of death in LN patients.

Conclusions

Clinicopathological characteristics, treatment responses and long-term outcomes differ remarkably in LN patients with different gender and pathological subtypes. New indicators of poor renal outcome were identified. Infections and TTP were the most common causes of death in LN patients.

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Acknowledgments

This work was partly supported by National Natural Science Foundation of China (Nos. 30800527 and 81270793). Our sincere thanks go to Professor Ye Tao, Zhangxue Hu, and all the staff of Nephrology Division for their help.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Author notes

    Authors and Affiliations

    1. Division of Nephrology, West China Hospital of Sichuan University, 37# Guoxue Rd, Chengdu, Sichuan, China

      Yi Tang, Ling Ji, XuHua Mi, Fei Liu, LiChuan Yang & Wei Qin

    2. West China Medical School of Sichuan University, Chengdu, Sichuan, China

      XiaoYan Zhang

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    1. Yi Tang
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    2. XiaoYan Zhang
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    3. Ling Ji
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    4. XuHua Mi
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    7. Wei Qin
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    Corresponding author

    Correspondence to Wei Qin.

    Additional information

    Yi Tang, XiaoYan Zhang and Ling Ji have contributed equally to this paper.

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    Tang, Y., Zhang, X., Ji, L. et al. Clinicopathological and outcome analysis of adult lupus nephritis patients in China. Int Urol Nephrol 47, 513–520 (2015). https://doi.org/10.1007/s11255-014-0903-y

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