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The frequency and outcome of lupus nephritis: results from an international inception cohort study.

Hanly, JG; O'Keeffe, AG; Su, L; Urowitz, MB; Romero-Diaz, J; Gordon, C; Bae, SC; ... Farewell, V; + view all (2015) The frequency and outcome of lupus nephritis: results from an international inception cohort study. Rheumatology (Oxford) , 55 (2) pp. 252-262. 10.1093/rheumatology/kev311. Green open access

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Abstract

Objective. To determine nephritis outcomes in a prospective multi-ethnic/racial SLE inception cohort. Methods. Patients in the Systemic Lupus International Collaborating Clinics inception cohort (≤15 months of SLE diagnosis) were assessed annually for estimated glomerular filtration rate (eGFR), proteinuria and end-stage renal disease (ESRD). Health-related quality of life was measured by the Short Form (36 questions) health survey questionnaire (SF-36) subscales, mental and physical component summary scores. Results. There were 1827 patients, 89% females, mean (S.D.) age 35.1 (13.3) years. The mean (S.D.) SLE duration at enrolment was 0.5 (0.3) years and follow-up 4.6 (3.4) years. LN occurred in 700 (38.3%) patients: 566/700 (80.9%) at enrolment and 134/700 (19.1%) during follow-up. Patients with nephritis were younger, more frequently men and of African, Asian and Hispanic race/ethnicity. The estimated overall 10-year incidence of ESRD was 4.3% (95% CI: 2.8%, 5.8%), and with nephritis was 10.1% (95% CI: 6.6%, 13.6%). Patients with nephritis had a higher risk of death (HR = 2.98, 95% CI: 1.48, 5.99; P = 0.002) and those with eGFR <30 ml/min at diagnosis had lower SF-36 physical component summary scores (P < 0.01) and lower Physical function, Physical role and Bodily pain scores. Over time, patients with abnormal eGFR and proteinuria had lower SF-36 mental component summary (P ≤ 0.02) scores compared to patients with normal values. Conclusion. LN occurred in 38.3% of SLE patients, frequently as the initial presentation, in a large multi-ethnic inception cohort. Despite current standard of care, nephritis was associated with ESRD and death, and renal insufficiency was linked to lower health-related quality of life. Further advances are required for the optimal treatment of LN.

Type: Article
Title: The frequency and outcome of lupus nephritis: results from an international inception cohort study.
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/rheumatology/kev311
Publisher version: http://dx.doi.org/10.1093/rheumatology/kev311
Language: English
Additional information: © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. This is a pre-copyedited, author-produced PDF of an article accepted for publication in Rheumatology following peer review. The version of record Hanly, JG; O'Keeffe, AG; Su, L; Urowitz, MB; Romero-Diaz, J; Gordon, C; Bae, SC; (2015) The frequency and outcome of lupus nephritis: results from an international inception cohort study. Rheumatology (Oxford) , 55 (2) pp. 252-262. 10.1093/rheumatology/kev311 is available online at: http://dx.doi.org/10.1093/rheumatology/kev311
Keywords: Inception cohort, lupus, nephritis, outcomes research, systemic lupus erythematosus
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Statistical Science
URI: https://discovery.ucl.ac.uk/id/eprint/1461856
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