Victoria Navarro-Compán, Marco Garrido-Cumbrera, Denis Poddubnyy, Christine Bundy, Souzi Makri, José Correa-Fernández, Shashank Akerkar, Jo Lowe, Elie Karam, Fernando Sommerfleck
Background
To assess gender differences in a large sample of patients included in the International Map of Axial Spondyloarthritis (IMAS) study from around the globe.
Method
IMAS is a cross-sectional online survey (2017–2022) of 5557 unselected axSpA patients from 27 countries. The current analysis assessed differences between males and females for: sociodemographic, health behaviors, disease characteristics, patient-reported outcomes, mental comorbidities, and treatments. Univariable and multivariable logistic regression analysis was used to evaluate the relationship between gender and disease characteristics, patient-reported outcomes, comorbidities, and treatments.
Results
Data from 5555 patients reporting gender were analyzed: 3492 from Europe, 769 from North America, 600 from Asia, 548 from Latin America, and 146 from Africa. Globally, 55.4% were females, with higher proportions in South Africa (82.2%) and lower in Asia (20.8%). Compared to males, a lower percentage of females smoked and consumed alcohol. The diagnostic delay was significantly longer (+2.4 years) in females, while the frequency of HLA-B27 positivity of axSpA was lower in females. The use of axSpA pharmacological treatment was more common in females with a higher proportion having ever taken nonsteroidal anti-inflammatory drugs (NSAIDs), conventional synthetic DMARDs (csDMARDs), and biologic DMARDs (bDMARDS).
Conclusions
Identifying the specific disease characteristics associated with gender in patients with axSpA may help to improve the diagnosis and management of the disease, and thereby reduce the disease burden for patients around the world.
{"title":"Females With Axial Spondyloarthritis Have Longer Diagnostic Delay and Higher Burden of the Disease. Results From the International Map of Axial Spondyloarthritis (IMAS)","authors":"Victoria Navarro-Compán, Marco Garrido-Cumbrera, Denis Poddubnyy, Christine Bundy, Souzi Makri, José Correa-Fernández, Shashank Akerkar, Jo Lowe, Elie Karam, Fernando Sommerfleck","doi":"10.1111/1756-185X.15433","DOIUrl":"10.1111/1756-185X.15433","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To assess gender differences in a large sample of patients included in the International Map of Axial Spondyloarthritis (IMAS) study from around the globe.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>IMAS is a cross-sectional online survey (2017–2022) of 5557 unselected axSpA patients from 27 countries. The current analysis assessed differences between males and females for: sociodemographic, health behaviors, disease characteristics, patient-reported outcomes, mental comorbidities, and treatments. Univariable and multivariable logistic regression analysis was used to evaluate the relationship between gender and disease characteristics, patient-reported outcomes, comorbidities, and treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 5555 patients reporting gender were analyzed: 3492 from Europe, 769 from North America, 600 from Asia, 548 from Latin America, and 146 from Africa. Globally, 55.4% were females, with higher proportions in South Africa (82.2%) and lower in Asia (20.8%). Compared to males, a lower percentage of females smoked and consumed alcohol. The diagnostic delay was significantly longer (+2.4 years) in females, while the frequency of HLA-B27 positivity of axSpA was lower in females. The use of axSpA pharmacological treatment was more common in females with a higher proportion having ever taken nonsteroidal anti-inflammatory drugs (NSAIDs), conventional synthetic DMARDs (csDMARDs), and biologic DMARDs (bDMARDS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Identifying the specific disease characteristics associated with gender in patients with axSpA may help to improve the diagnosis and management of the disease, and thereby reduce the disease burden for patients around the world.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"27 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To identify risk factors associated with major adverse cardiovascular events (MACE) and malignancies in patients with rheumatoid arthritis (RA) using real-world data from Japan.
Methods
This cohort study used the Real World Data database of medical institutions in Japan. Eligible patients (January 2013–December 2021) had ≥ 1 RA diagnosis, were aged ≥ 18 years, prescribed ≥ 1 antirheumatic drug, had no psoriasis diagnosis, and had a record postindex. Patients had no myocardial infarction/stroke ≤ 31 days (MACE cohort) or malignancy < 1 year (malignancy cohort) before index. Cohorts were determined by incidence of initial MACE or malignancy. Known/exploratory variables were selected using Cox regression models.
Results
Across MACE (n = 16 012) and malignancy (n = 14 545) cohorts, most patients were female and aged ≥ 65 years. Overall, 214 MACE per 43964.7 patient-years (incidence rate 0.49 per 100 patient-years) and 315 malignancies per 40251.6 patient-years (incidence rate 0.78 per 100 patient-years) occurred. Male sex, older age (≥ 65 years), hypertension, renal disease, cerebrovascular disease, and prior X-ray examination were significantly associated with increased MACE risk. Male sex, older age (≥ 50 years), nonsteroidal anti-inflammatory drug use, emphysema, serious infection, malignancy history, and prior X-ray examination were significantly associated with increased malignancy risk. Conversely, glucocorticoid use and fracture diagnosis were significantly associated with reduced malignancy risk.
Conclusion
In patients with RA in Japan, male sex, older age, and prior X-ray examination were associated with increased MACE and malignancy risk.
{"title":"Risk Factors Associated With Major Adverse Cardiovascular Events and Malignancies in Patients With Rheumatoid Arthritis in a Real-World Setting in Japan","authors":"Kunihiro Yamaoka, Naonobu Sugiyama, Masato Hoshi, Joo-Young Jo, Kichul Shin, Toshitaka Hirano","doi":"10.1111/1756-185X.15448","DOIUrl":"10.1111/1756-185X.15448","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify risk factors associated with major adverse cardiovascular events (MACE) and malignancies in patients with rheumatoid arthritis (RA) using real-world data from Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cohort study used the Real World Data database of medical institutions in Japan. Eligible patients (January 2013–December 2021) had ≥ 1 RA diagnosis, were aged ≥ 18 years, prescribed ≥ 1 antirheumatic drug, had no psoriasis diagnosis, and had a record postindex. Patients had no myocardial infarction/stroke ≤ 31 days (MACE cohort) or malignancy < 1 year (malignancy cohort) before index. Cohorts were determined by incidence of initial MACE or malignancy. Known/exploratory variables were selected using Cox regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across MACE (<i>n</i> = 16 012) and malignancy (<i>n</i> = 14 545) cohorts, most patients were female and aged ≥ 65 years. Overall, 214 MACE per 43964.7 patient-years (incidence rate 0.49 per 100 patient-years) and 315 malignancies per 40251.6 patient-years (incidence rate 0.78 per 100 patient-years) occurred. Male sex, older age (≥ 65 years), hypertension, renal disease, cerebrovascular disease, and prior X-ray examination were significantly associated with increased MACE risk. Male sex, older age (≥ 50 years), nonsteroidal anti-inflammatory drug use, emphysema, serious infection, malignancy history, and prior X-ray examination were significantly associated with increased malignancy risk. Conversely, glucocorticoid use and fracture diagnosis were significantly associated with reduced malignancy risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with RA in Japan, male sex, older age, and prior X-ray examination were associated with increased MACE and malignancy risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"27 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chen Li, Yuwei Wang, Di Jin, Jingyan Guo, Zhimin Lin, Jingyuan Fu, Sheng-Guang Li
Behcet's disease is a rare, chronic inflammatory disorder that can affect various organs, with large vessel involvement being particularly uncommon. This case report discusses a 17-year-old male with Behcet's disease who presented with a rapidly enlarging, painful mass in the right groin region, later diagnosed as a femoral artery aneurysm. The patient underwent successful surgical intervention and was subsequently managed with immunosuppressive therapy to prevent relapse.
{"title":"Case Report: A Ticking Time Bomb: Femoral Artery Aneurysm as a Complication of Behcet's Disease in Adolescents","authors":"Chen Li, Yuwei Wang, Di Jin, Jingyan Guo, Zhimin Lin, Jingyuan Fu, Sheng-Guang Li","doi":"10.1111/1756-185X.15445","DOIUrl":"10.1111/1756-185X.15445","url":null,"abstract":"<div>\u0000 \u0000 <p>Behcet's disease is a rare, chronic inflammatory disorder that can affect various organs, with large vessel involvement being particularly uncommon. This case report discusses a 17-year-old male with Behcet's disease who presented with a rapidly enlarging, painful mass in the right groin region, later diagnosed as a femoral artery aneurysm. The patient underwent successful surgical intervention and was subsequently managed with immunosuppressive therapy to prevent relapse.</p>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"27 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Behind Anti-MDA5 Antibody: Symbol of A Specific Disease or A Phenomenon?","authors":"Huaiya Xie, Luo Wang, Junping Fan, Xinlun Tian","doi":"10.1111/1756-185X.15417","DOIUrl":"10.1111/1756-185X.15417","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"27 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qinxue Wang, Jun Liu, Yuanze Ma, Yi Han, Haobin Huang
Aim
To investigate the relationship between the ionized-to-total calcium ratio and the incidence of acute kidney injury (AKI) in critically ill patients with autoimmune diseases.
Methods
A retrospective study was conducted utilizing data from the Medical Information Mart for Intensive Care IV database. In-hospital AKI was the primary outcome. Patients were classified into four distinct categories depending on the calcium ratio. Cox proportional hazards model and restricted cubic spline (RCS) analysis were applied to assess the association between the calcium ratio and AKI risk. Subgroup analyses were conducted to evaluate the consistency of this association across various patient characteristics.
Results
A total of 1054 critically ill patients with autoimmune diseases were enrolled and stratified by calcium ratio quartiles into four groups (< 0.515; 0.515–0.546; 0.546–0.576; > 0.576). Cumulative incidence curves showed significant difference in AKI risk among the four groups. Patients in the highest calcium ratio quartile experienced a markedly reduced likelihood of AKI versus those in the lowest, especially in the fully adjusted model (HR = 0.66, 95% CI 0.51–0.84, p < 0.001). RCS analysis demonstrated an obvious nonlinear relationship, showing a steep decline in AKI risk with increasing calcium ratio, which eventually plateaued. This protective effect of higher calcium ratios against AKI was consistent across subgroups, except in those with chronic kidney disease at baseline.
Conclusion
The ionized-to-total calcium ratio proves to be significantly associated with the development of AKI in critically ill patients with autoimmune diseases, with its elevation indicating a reduced AKI risk.
{"title":"Association Between the Ionized-to-Total Calcium Ratio and the Risk of Acute Kidney Injury in Patients With Severe Autoimmune Diseases: A Retrospective Analysis From the MIMIC-IV Database","authors":"Qinxue Wang, Jun Liu, Yuanze Ma, Yi Han, Haobin Huang","doi":"10.1111/1756-185X.15446","DOIUrl":"10.1111/1756-185X.15446","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To investigate the relationship between the ionized-to-total calcium ratio and the incidence of acute kidney injury (AKI) in critically ill patients with autoimmune diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study was conducted utilizing data from the Medical Information Mart for Intensive Care IV database. In-hospital AKI was the primary outcome. Patients were classified into four distinct categories depending on the calcium ratio. Cox proportional hazards model and restricted cubic spline (RCS) analysis were applied to assess the association between the calcium ratio and AKI risk. Subgroup analyses were conducted to evaluate the consistency of this association across various patient characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1054 critically ill patients with autoimmune diseases were enrolled and stratified by calcium ratio quartiles into four groups (< 0.515; 0.515–0.546; 0.546–0.576; > 0.576). Cumulative incidence curves showed significant difference in AKI risk among the four groups. Patients in the highest calcium ratio quartile experienced a markedly reduced likelihood of AKI versus those in the lowest, especially in the fully adjusted model (HR = 0.66, 95% CI 0.51–0.84, <i>p</i> < 0.001). RCS analysis demonstrated an obvious nonlinear relationship, showing a steep decline in AKI risk with increasing calcium ratio, which eventually plateaued. This protective effect of higher calcium ratios against AKI was consistent across subgroups, except in those with chronic kidney disease at baseline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The ionized-to-total calcium ratio proves to be significantly associated with the development of AKI in critically ill patients with autoimmune diseases, with its elevation indicating a reduced AKI risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"27 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Rheumatoid arthritis (RA) is a chronic autoimmune disorder primarily affecting the joints, leading to pain, swelling, and functional impairment. Epidemiological data indicate that RA affects approximately 0.5%–1% of the global population, with a higher prevalence in women, typically manifesting in middle age. There are numerous extraarticular manifestations (EAMs) in RA, among which lung damage, especially interstitial lung disease (ILD), deteriorate the evolution and survival of these patients [<span>1</span>]. The prevalence of RA-ILD was approximately 18.7%, and the risk for RA-ILD including male sex, older age, having a smoking history, pulmonary comorbidities, older age of RA onset, longer RA duration, positive RF, positive ACPA, higher ESR, moderate and high DAS28 (≥ 3.2), rheumatoid nodules, leflunomide use, and steroid use. Additionally, biological agent use was a protective factor [<span>2</span>].</p><p>Chronic obstructive pulmonary disease (COPD), characterized by chronic airway inflammation and progressive airflow limitation, is a debilitating respiratory condition often resulting from long-term exposure to harmful substances such as tobacco smoke and environmental pollutants. This disease leads to the gradual destruction of lung tissue, significantly impairs patients' daily activities and quality of life, and is a leading cause of morbidity and mortality worldwide. The disease's progression is typically marked by exacerbations, which are acute episodes of worsening respiratory symptoms, often triggered by infections or environmental factors. These exacerbations further contribute to impaired lung function and a decline in overall health status [<span>3</span>]. Comprehensive management strategies, including smoking cessation, pharmacotherapy, and pulmonary rehabilitation, are crucial in mitigating the impact of COPD on patients' lives.</p><p>Both RA and COPD have high prevalence rates and impose substantial social and medical burdens and considerable pressure on patients' quality of life and healthcare systems [<span>4</span>]. Compared to ILD, which gets more attention in RA patients, COPD is rarely discussed in the lung complications of RA; maybe this is because COPD is more prevalent in older men with a smoking history, and RA is more prevalent in middle-aged women without smoking. Although COPD and ILD have distinct clinical features, both diseases may coexist in a patient because they share similar risk factors, such as smoking, male sex, and old age [<span>5</span>].</p><p>Recently, increasing evidence suggests that RA patients are at an elevated risk of developing COPD. A nationwide retrospective cohort study reported that RA was shown to be associated with an increased risk of COPD development, augmented by seropositivity [<span>6</span>]. Cao et al. [<span>6</span>] reported the causal association of RA and COPD from a Mendelian randomization study. Kai et al. [<span>7</span>] also reported that a significant bidirectiona
{"title":"Editorial: Rheumatoid Arthritis and Chronic Obstructive Pulmonary Disease: Pathogenesis and Treatment Challenges","authors":"Cheng-Hsien Hung, Li-Yu Lu, An-Ping Huo","doi":"10.1111/1756-185X.15440","DOIUrl":"10.1111/1756-185X.15440","url":null,"abstract":"<p>Rheumatoid arthritis (RA) is a chronic autoimmune disorder primarily affecting the joints, leading to pain, swelling, and functional impairment. Epidemiological data indicate that RA affects approximately 0.5%–1% of the global population, with a higher prevalence in women, typically manifesting in middle age. There are numerous extraarticular manifestations (EAMs) in RA, among which lung damage, especially interstitial lung disease (ILD), deteriorate the evolution and survival of these patients [<span>1</span>]. The prevalence of RA-ILD was approximately 18.7%, and the risk for RA-ILD including male sex, older age, having a smoking history, pulmonary comorbidities, older age of RA onset, longer RA duration, positive RF, positive ACPA, higher ESR, moderate and high DAS28 (≥ 3.2), rheumatoid nodules, leflunomide use, and steroid use. Additionally, biological agent use was a protective factor [<span>2</span>].</p><p>Chronic obstructive pulmonary disease (COPD), characterized by chronic airway inflammation and progressive airflow limitation, is a debilitating respiratory condition often resulting from long-term exposure to harmful substances such as tobacco smoke and environmental pollutants. This disease leads to the gradual destruction of lung tissue, significantly impairs patients' daily activities and quality of life, and is a leading cause of morbidity and mortality worldwide. The disease's progression is typically marked by exacerbations, which are acute episodes of worsening respiratory symptoms, often triggered by infections or environmental factors. These exacerbations further contribute to impaired lung function and a decline in overall health status [<span>3</span>]. Comprehensive management strategies, including smoking cessation, pharmacotherapy, and pulmonary rehabilitation, are crucial in mitigating the impact of COPD on patients' lives.</p><p>Both RA and COPD have high prevalence rates and impose substantial social and medical burdens and considerable pressure on patients' quality of life and healthcare systems [<span>4</span>]. Compared to ILD, which gets more attention in RA patients, COPD is rarely discussed in the lung complications of RA; maybe this is because COPD is more prevalent in older men with a smoking history, and RA is more prevalent in middle-aged women without smoking. Although COPD and ILD have distinct clinical features, both diseases may coexist in a patient because they share similar risk factors, such as smoking, male sex, and old age [<span>5</span>].</p><p>Recently, increasing evidence suggests that RA patients are at an elevated risk of developing COPD. A nationwide retrospective cohort study reported that RA was shown to be associated with an increased risk of COPD development, augmented by seropositivity [<span>6</span>]. Cao et al. [<span>6</span>] reported the causal association of RA and COPD from a Mendelian randomization study. Kai et al. [<span>7</span>] also reported that a significant bidirectiona","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"27 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185X.15440","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caleb S. Alexander, Prashant Kaushik, Bryan J. Butel, David L. Ray
{"title":"Inter- and Intraobserver Variation of Median Nerve Cross-Sectional Area Measurement Using Point-of-Care Ultrasound","authors":"Caleb S. Alexander, Prashant Kaushik, Bryan J. Butel, David L. Ray","doi":"10.1111/1756-185X.15442","DOIUrl":"10.1111/1756-185X.15442","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"27 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hyemin Jeong, Sung-Eun Choi, Ji-Hyoun Kang, Ji Shin Lee, Yoo-Duk Choi, Dong-Jin Park, Shin-Seok Lee
Objective
This study aims to determine whether the concurrent presence of tubulointerstitial inflammation (TII) and tubulointerstitial damage (TID) predicts the progression of chronic kidney disease (CKD) in patients with lupus nephritis (LN).
Methods
Data from 175 LN patients, collected at the time of renal biopsy, were analyzed. Patients were stratified into two groups based on the presence or absence of coexisting TII/TID. Uni- and multivariable Cox proportional hazard regression models were utilized to identify independent risk factors for CKD in LN patients.
Results
Of 175 patients, 110 (62.9%) exhibited coexisting TII/TID, whereas 65 (37.1%) did not. Patients with coexisting TII/TID tended to be older and presented with higher levels of ESR and 24-h proteinuria, as well as lower levels of eGFR and hemoglobin compared to those without coexisting TII/TID. Over a mean follow-up period of 89.9 months, CKD and end-stage renal disease occurred more frequently in patients with coexisting TII/TID. Notably, the presence of coexisting TII/TID was associated with a higher risk of CKD progression, with adjusted hazard ratios of 2.667 (95% CI: 1.333, 5.335, p = 0.006) for all LN patients, 3.265 (95% CI: 1.451, 7.345, p = 0.004) for those with class III, IV, and V LN, and 3.045 (95% CI: 1.289, 7.195, p = 0.011) for those with class III, IV, V LN, and eGFR ≥ 30 mL/min/1.73 m2.
Conclusions
LN patients with coexisting TII/TID are at a heightened risk of kidney function deterioration at LN onset and subsequent development of CKD over the long term.
{"title":"Coexisting Tubulointerstitial Inflammation and Damage Is a Risk Factor for Chronic Kidney Disease in Patients With Lupus Nephritis","authors":"Hyemin Jeong, Sung-Eun Choi, Ji-Hyoun Kang, Ji Shin Lee, Yoo-Duk Choi, Dong-Jin Park, Shin-Seok Lee","doi":"10.1111/1756-185X.15444","DOIUrl":"10.1111/1756-185X.15444","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to determine whether the concurrent presence of tubulointerstitial inflammation (TII) and tubulointerstitial damage (TID) predicts the progression of chronic kidney disease (CKD) in patients with lupus nephritis (LN).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 175 LN patients, collected at the time of renal biopsy, were analyzed. Patients were stratified into two groups based on the presence or absence of coexisting TII/TID. Uni- and multivariable Cox proportional hazard regression models were utilized to identify independent risk factors for CKD in LN patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 175 patients, 110 (62.9%) exhibited coexisting TII/TID, whereas 65 (37.1%) did not. Patients with coexisting TII/TID tended to be older and presented with higher levels of ESR and 24-h proteinuria, as well as lower levels of eGFR and hemoglobin compared to those without coexisting TII/TID. Over a mean follow-up period of 89.9 months, CKD and end-stage renal disease occurred more frequently in patients with coexisting TII/TID. Notably, the presence of coexisting TII/TID was associated with a higher risk of CKD progression, with adjusted hazard ratios of 2.667 (95% CI: 1.333, 5.335, <i>p</i> = 0.006) for all LN patients, 3.265 (95% CI: 1.451, 7.345, <i>p</i> = 0.004) for those with class III, IV, and V LN, and 3.045 (95% CI: 1.289, 7.195, <i>p</i> = 0.011) for those with class III, IV, V LN, and eGFR ≥ 30 mL/min/1.73 m<sup>2</sup>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LN patients with coexisting TII/TID are at a heightened risk of kidney function deterioration at LN onset and subsequent development of CKD over the long term.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"27 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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