Clinical comparisons between previously diagnosed SLE and newly diagnosed SLE by kidney biopsy.

Q1 Medicine Auto-Immunity Highlights Pub Date : 2020-12-02 DOI:10.1186/s13317-020-00140-2
Pantipa Tonsawan, Kittisak Sawanyawisuth
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引用次数: 2

Abstract

Background: Lupus nephritis is a type of major organ involvement in systemic lupus erythematosus (SLE) patients that leads to higher rates of morbidity and mortality and may present initially in 28% of SLE patients. However, there are limited data available on clinical differences or predictors for biopsy-proven lupus nephritis in established versus newly diagnosed SLE cases.

Methods: Adult patients undergoing kidney biopsy for the first time with a diagnosis of lupus nephritis were eligible for inclusion. Patients were categorized into two groups: those with previously diagnosed SLE and those with newly diagnosed SLE by kidney biopsy. Factors associated with newly diagnosed SLE were determined using logistic regression analysis.

Results: There were 68 patients diagnosed with lupus nephritis by kidney biopsy. Of those, 31 cases (45.58%) were newly diagnosed. The newly diagnosed SLE group was significantly older (36.87 vs 30.95 years) and had a lower proportion of females (74.19% vs 91.89%) than the previously diagnosed group. A new-onset hypertension was the only factor independently associated with newly diagnosed SLE by kidney biopsy. The adjusted odds ratio (95% CI) was 5.152 (1.046, 25.363).

Conclusions: Nearly half of the biopsy-proven lupus nephritis cases in this study were patients with newly diagnosed SLE. Patients with previously diagnosed SLE and newly diagnosed SLE by kidney biopsy had clinical differences.

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早期SLE诊断与新诊断SLE肾活检的临床比较。
背景:狼疮肾炎是系统性红斑狼疮(SLE)患者主要器官受累的一种类型,导致较高的发病率和死亡率,最初可能出现在28%的SLE患者中。然而,关于活检证实的狼疮性肾炎与新诊断的SLE病例的临床差异或预测因素的数据有限。方法:首次接受肾活检诊断为狼疮肾炎的成年患者符合入选条件。患者分为两组:先前诊断为SLE的患者和通过肾活检新诊断为SLE的患者。采用logistic回归分析确定与新诊断SLE相关的因素。结果:68例患者经肾活检诊断为狼疮性肾炎。其中31例(45.58%)为新发病例。新诊断SLE组年龄明显大于前诊断组(36.87 vs 30.95),女性比例(74.19% vs 91.89%)明显低于前诊断组。新发高血压是唯一与肾活检新诊断SLE独立相关的因素。校正优势比(95% CI)为5.152(1.046,25.363)。结论:本研究中近一半活检证实的狼疮性肾炎病例是新诊断的SLE患者。既往SLE患者与新诊断SLE患者肾活检有临床差异。
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