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Factors Associated With Aggravation of Tubulointerstitial Damage on Repeated Biopsies in Lupus Nephritis Patients With Treatment Failure

Authors
 Oh Chan Kwon  ;  Yong Mee Cho  ;  Ji Seon Oh  ;  Seokchan Hong  ;  Chang-Keun Lee  ;  Bin Yoo  ;  Yong-Gil Kim 
Citation
 CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, Vol.38(2) : 239-244, 2020-04 
Journal Title
 CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 
ISSN
 0392-856X 
Issue Date
2020-04
MeSH
Biopsy / adverse effects* ; Disease Progression ; Humans ; Hydroxychloroquine / therapeutic use ; Kidney / pathology ; Kidney Tubules / pathology* ; Lupus Nephritis* / pathology ; Prognosis ; Retrospective Studies ; Treatment Failure
Abstract
Objectives: Tubulointerstitial damage in lupus nephritis (LN) is an important predictor of renal prognosis. Here, we investigated the factors associated with aggravation of tubulointerstitial damage in patients with LN. Methods: Patients with LN, who underwent repeated renal biopsy due to treatment failure at a tertiary referral hospital between 1997 and 2017 were identified. Clinicopathologic and laboratory data were collected. Aggravation of tubulointerstitial damage (tubular atrophy and/or interstitial fibrosis) was defined as progression of severity from none-to-mild to moderate-to-severe. Factors associated with aggravation of tubulointerstitial damage were evaluated using logistic regression analysis. Results: A total of 52 LN patients were included for analysis. Aggravation of tubulointerstitial damage at the second renal biopsy was observed in 19 (36.5%) patients. In multivariable logistic regression analysis, use of hydroxychloroquine (adjusted OR 0.215, 95% CI 0.049-0.941, p=0.041) was inversely associated with aggravation of tubulointerstitial damage, and higher renal component of systemic lupus erythematosus disease activity index (SLEDAI) at first biopsy (adjusted OR 1.331, 95% CI 1.083-1.636, p=0.007) was associated with aggravation of tubulointerstitial damage. In terms of use of HCQ, both length of treatment with HCQ (adjusted OR 0.974, 95% CI 0.951-0.998, p=0.036) and cumulative dose of HCQ (log transferred value) (adjusted OR 0.485, 95% CI 0.262-0.896, p=0.020) were inversely associated with aggravation of tubulointerstitial damage. Conclusions: Use of hydroxychloroquine was associated with lower risk of aggravation in tubulointerstitial damage, and higher renal component of SLEDAI at first renal biopsy was associated with higher risk of aggravation in tubulointerstitial damage.
Full Text
https://www.clinexprheumatol.org/abstract.asp?a=13982
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/22282913/176084
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