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Comparison of clinical, serological, and prognostic differences among juvenile-, adult-, and late-onset lupus nephritis in Korean patients

Clinical Rheumatology volume 36, pages 1289–1295 (2017)Cite this article

Abstract

We investigated whether lupus nephritis (LN) patients could be distinguished based on the time of disease onset and, if so, whether the groups differed in their clinical and laboratory features and long-term prognosis in ethnically homogeneous Korean patients. We enrolled 117 systemic lupus erythematosus patients with available clinical data at the time of renal biopsy of LN. Sociodemographic, clinical, and laboratory data and concomitant diseases were evaluated at the time of renal biopsy. We divided LN patients, according to age at LN diagnosis, into three groups: juvenile-onset LN (JLN, diagnosed at ≤18 years), adult-onset LN (ALN, diagnosed at 18–50 years), and late-onset LN (LLN, diagnosed at >50 years) and compared demographic, clinical, histological, and laboratory findings. We also compared treatment and long-term prognosis of LN. Of the 117 LN patients, 20 (17.8%), 84 (71.3%), and 13 (10.9%) were JLN, ALN, and LLN patients, respectively. LLN patients showed higher white blood cell counts and lower estimated glomerular filtration rate than ALN or LLN patients. LLN patients had higher chronicity indices and scores. Anti-Ro antibodies were found more frequently in ALN patients, and lower complement levels were more common in JLN patients. During a mean follow-up of 76.5 months, development of chronic kidney disease and death were higher in LLN patients than in JLN and ALN patients. LLN patients showed higher chronicity indices and deterioration of kidney function and death in long-term follow-up compared with JLN and ALN patients. Therefore, LLN patients should be carefully monitored to avoid poor outcomes.

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Acknowledgements

The authors also thank the patients and their families for their participation.

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Author notes

  1. Ji-Hyoun Kang and Dong-Jin Park contributed equally to this work.

Affiliations

  1. Department of Rheumatology, Chonnam National University Hospital & Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea

    Ji-Hyoun Kang, Dong-Jin Park, Kyung-Eun Lee & Shin-Seok Lee

  2. Department of Pathology, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea

    Ji Shin Lee & Yoo-Duk Choi

Authors
  1. Ji-Hyoun Kang
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  2. Dong-Jin Park
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  3. Kyung-Eun Lee
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  4. Ji Shin Lee
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  5. Yoo-Duk Choi
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  6. Shin-Seok Lee
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Corresponding author

Correspondence to Shin-Seok Lee.

Ethics declarations

This research complied with the Helsinki Declaration. This study was approved by the Institutional Review Board of CNUH (IRB No. CNUH-2014-239), and informed consent was obtained at the time of registry enrollment.

Disclosures

None.

Funding

This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention (2014-E63002-00) and a grant (CRI13904-24, CRI16039-22) from Chonnam National University Hospital Biomedical Research Institute.

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Kang, JH., Park, DJ., Lee, KE. et al. Comparison of clinical, serological, and prognostic differences among juvenile-, adult-, and late-onset lupus nephritis in Korean patients. Clin Rheumatol 36, 1289–1295 (2017). https://doi.org/10.1007/s10067-017-3641-6

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  • DOI: https://doi.org/10.1007/s10067-017-3641-6

Keywords

  • Age
  • Lupus nephritis
  • Onset
  • Systemic lupus erythematosus