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Renal flare in class V lupus nephritis: increased risk in patients with tubulointerstitial lesions

Authors
 Oh Chan Kwon  ;  Yong Mee Cho  ;  Ji Seon Oh  ;  Seokchan Hong  ;  Chang-Keun Lee  ;  Bin Yoo  ;  Yong-Gil Kim 
Citation
 RHEUMATOLOGY INTERNATIONAL, Vol.39(12) : 2061-2067, 2019 
Journal Title
 RHEUMATOLOGY INTERNATIONAL 
ISSN
 0172-8172 
Issue Date
2019
Keywords
Flare ; Interstitial fibrosis ; Membranous lupus nephritis ; Tubular atrophy ; Tubulointerstitial inflammation
Abstract
The objective of this study is to investigate the risk factors of renal flare in patients with membranous lupus nephritis (class V lupus nephritis). Biopsy-proven pure membranous lupus nephritis patients diagnosed between January 1997 and September 2017 were studied. We assessed and compared the clinical and pathological parameters between patients who experienced renal flare and those who did not. To identify risk factors of renal flare, multivariable Cox proportional hazard regression analysis was performed. Out of the 53 patients with pure membranous lupus nephritis, 17 patients (32.1%) experienced renal flare during a median follow-up of 121.5 months (range 44.4-196.9). Patients who experienced renal flare had significantly higher proportion of tubulointerstitial inflammation (76.5% vs. 36.1%, p = 0.006) and tubular atrophy/interstitial fibrosis (70.6% vs. 27.8%, p = 0.003) at baseline. In multivariable Cox proportional hazard regression analysis, the presence of tubulointerstitial inflammation [adjusted hazard ratio (HR) 5.532, 95% confidence interval (CI) 1.722-17.776, p = 0.004] and tubular atrophy/interstitial fibrosis (adjusted HR 4.328, 95% CI 1.450-12.916, p = 0.009) at baseline was significantly associated with increased risk of renal flare. The presence of tubulointerstitial inflammation and tubular atrophy/interstitial fibrosis is associated with increased risk of renal flare in patients with membranous lupus nephritis.
Full Text
https://link.springer.com/article/10.1007%2Fs00296-019-04369-7
DOI
10.1007/s00296-019-04369-7
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Oh Chan(권오찬)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/174567
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