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Author Notes:

Email: tilori@emory.edu

Conceived and designed the experiments: TOI ABF LP AOO.

Performed the experiments: TOI NE AO OO HF JC.

Analyzed the data: TOI NE HF DAA.

Contributed reagents/materials/analysis tools: ABF JN.

Wrote the paper: TOI NE AO JC JN DAA HF OO ABF LP AOO.

We would like to thank the Renal Division, Emory University School of Medicine and Department of Medicine Data Analytics and Biostatistics Core for the support of this project and Shailesh Nair for his invaluable contribution to this project.

Due to ethical considerations, data are available upon request from the corresponding author to interested researchers, pending ethical approval.

The authors received no specific funding for this work.

Subjects:

Research Funding:

None

Keywords:

  • SCIENCE & TECHNOLOGY
  • MULTIDISCIPLINARY SCIENCES
  • SCIENCE & TECHNOLOGY - OTHER TOPICS
  • MEMBRANOUS GLOMERULONEPHRITIS
  • HISTOLOGIC PATTERNS
  • RENAL INVOLVEMENT
  • CLINICAL COURSE
  • ERYTHEMATOSUS
  • CLASSIFICATION
  • FEATURES
  • PROGNOSIS
  • DISCRETE
  • REGISTRY

Comparison of Outcomes between Individuals with Pure and Mixed Lupus Nephritis: A Retrospective Study

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Journal Title:

PLoS ONE

Volume:

Volume 11, Number 6

Publisher:

, Pages e0157485-e0157485

Type of Work:

Article | Final Publisher PDF

Abstract:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Introduction: Lupus nephritis (LN) is a serious organ manifestation of systemic lupus erythematosus. Histologic overlap is relatively common in the six pathologic classes (I to VI) of LN. For example, mixed proliferative LN (MPLN) often includes features of classes III & V or classes IV & V combined. We performed a comparative evaluation of renal outcomes in patients with MPLN to patients with pure proliferative LN (PPLN) against pre-specified renal outcomes, and we also identified predictor of clinical outcomes among those with PPLN and MPLN. Hypothesis: Individuals with MPLN will have worse short-term renal outcomes compared to those with PPLN. Methods: We retrospectively reviewed 278 adult LN patients (≥18 years old) identified from an Emory University Hospital registry of native renal biopsies performed between January 2000 and December 2011. The final analytic sample consisted of individuals with a diagnosis of PPLN (n = 60) and MPLN (n = 96). We analyzed differences in clinical and laboratory characteristics at baseline. We also assessed associations between LN category and renal outcomes (complete remission and time to ESRD) with logistic and Cox proportional hazards models within two years of baseline. Results: The study population was predominantly female (83.97%) and African American (71.8%) with a mean age of 33.4 years at baseline. Over a median follow up of 1.02 years, we did not find any statistically significant associations between MPLN and the development of ESRD or remission when compared to patients with PPLN (adjusted HR = 0.30, 95% CI = 0.07, 1.26). Conclusion: There was no association between mixed or pure histopathologic features of LN at presentation and rate of complete or partial remission but higher baseline eGFR was associated with a lower probability of complete remission among patients with lupus nephritis.

Copyright information:

© 2016 Ilori et al.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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