Long-term outcome of Chinese patients with membranous lupus nephropathy

A retrospective analysis of the long-term outcome of patients with membranous lupus nephropathy (MLN) was conducted. One hundred Chinese patients, 90 females and 10 males with a mean age of 32 ± 9 years, with systemic lupus erythematosus and biopsy-proven MLN (ISN/RPS2003 classification criteria) we...

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Bibliographic Details
Published in:Lupus 2008-01, Vol.17 (1), p.56-61
Main Authors: Sun, H.O., Hu, W.X., Xie, H.L., Zhang, H.T., Chen, H.P., Zeng, C.H., Liu, Z.H., Li, L.S.
Format: Article
Language:English
Subjects:
Adult
Antibodies
Asian Continental Ancestry Group - statistics & numerical data
Biopsy
Blood pressure
China - epidemiology
Creatinine
Disease
Disease Progression
Female
Follow-Up Studies
Glomerulonephritis, Membranous - complications
Glomerulonephritis, Membranous - ethnology
Glomerulonephritis, Membranous - etiology
Glomerulonephritis, Membranous - mortality
Glomerulonephritis, Membranous - pathology
Glomerulonephritis, Membranous - therapy
Hospitals
Humans
Hypertension
Kaplan-Meier Estimate
Kidney Failure, Chronic - ethnology
Kidney Failure, Chronic - etiology
Kidney Failure, Chronic - mortality
Kidney Failure, Chronic - pathology
Kidney Failure, Chronic - therapy
Lupus
Lupus Erythematosus, Systemic - complications
Lupus Erythematosus, Systemic - ethnology
Lupus Erythematosus, Systemic - mortality
Lupus Erythematosus, Systemic - pathology
Lupus Erythematosus, Systemic - therapy
Lupus Nephritis - complications
Lupus Nephritis - ethnology
Lupus Nephritis - etiology
Lupus Nephritis - mortality
Lupus Nephritis - pathology
Lupus Nephritis - therapy
Male
Medical prognosis
Microscopy
Nephrology
Patients
Proportional Hazards Models
Remission (Medicine)
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
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Summary:A retrospective analysis of the long-term outcome of patients with membranous lupus nephropathy (MLN) was conducted. One hundred Chinese patients, 90 females and 10 males with a mean age of 32 ± 9 years, with systemic lupus erythematosus and biopsy-proven MLN (ISN/RPS2003 classification criteria) were enrolled in this study. The patient and renal survivals were estimated by the Kaplan—Meier method and the risk factors associated with end-stage renal failure (ESRF) were assessed by the Cox proportional hazards regression analysis. The mean follow-up of all patients was 77.6 ± 56 months. During follow-up, two patients died. Patient survival at 5 and 10 years was 98%. Renal survival at 5 and 10 years was 96.1% and 92.7%, respectively. Severe tubular-intersticial lesion (HR 66.514), nephrotic range proteinuria (HR 19.159) and refractoriness to treatments (HR 9.834) were independent risk factors for developing ESRF. Three of the six patients with ESRF had severe tubular-interstitial lesions on initial biopsy. Twenty-one patients underwent a repeat biopsy after 33months' (median time) follow-up, eight (38.1%) of these (class V superimposed class IV in 5, class V superimposed class III in 2 and class VI in 1) had transformed and three (37.5%) of them progressed to ESRF. Complications included infection (13%), thrombosis (3%), avascular necrosis (3%), diabetes mellitus (4%) and skin cancer (1%). The rate of patient and renal survival was high in this group of patients with MLN.
ISSN:0961-2033
1477-0962
DOI:10.1177/0961203307083443