1. Longitudinal associations of active renal disease with irreversible organ damage accrual in systemic lupus erythematosus
- Author
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Rangi Kandane-Rathnayake, Madelynn Chan, S-F Luo, Chak Sing Lau, Sargunan Sockalingam, S A Navarra, Sean O'Neill, Laniyati Hamijoyo, J R Kent, Masayoshi Harigai, Fiona Goldblatt, Alberta Hoi, Leonid Zamora, Eric F Morand, Aisha Lateef, Vera Golder, Mandana Nikpour, Yasuhiro Katsumata, Y-Jj Wu, and Worawit Louthrenoo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Internationality ,Adolescent ,Lupus nephritis ,Renal function ,Disease ,Kidney ,Severity of Illness Index ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Internal medicine ,Severity of illness ,Humans ,Lupus Erythematosus, Systemic ,Medicine ,Longitudinal Studies ,Prospective Studies ,030212 general & internal medicine ,Young adult ,skin and connective tissue diseases ,Prospective cohort study ,Aged ,Proportional Hazards Models ,030203 arthritis & rheumatology ,Lupus erythematosus ,business.industry ,Proportional hazards model ,Middle Aged ,medicine.disease ,Lupus Nephritis ,Disease Progression ,Female ,business ,Glomerular Filtration Rate - Abstract
Objective To examine longitudinal associations of active lupus nephritis with organ damage accrual in patients with systemic lupus erythematosus (SLE). Methods This study was performed using data from a large multinational prospective cohort. Active lupus nephritis at any visit was defined by the presence of urinary casts, proteinuria, haematuria or pyuria, as indicated by the cut-offs in the SLE Disease Activity Index (SLEDAI)-2K, collected at each visit. Organ damage accrual was defined as a change of SLICC-ACR Damage Index (SDI) score >0 units between baseline and final annual visits. Renal damage accrual was defined if there was new damage recorded in renal SDI domains (estimated glomerular filtration rate 3.5 g per 24 h/end-stage kidney disease). Time-dependent hazard regression analyses were used to examine the associations between active lupus nephritis and damage accrual. Results Patients ( N = 1735) were studied during 12,717 visits for a median (inter-quartile range) follow-up period of 795 (532, 1087) days. Forty per cent of patients had evidence of active lupus nephritis at least once during the study period, and active lupus nephritis was observed in 3030 (24%) visits. Forty-eight per cent of patients had organ damage at baseline and 14% accrued organ damage. Patients with active lupus nephritis were 52% more likely to accrue any organ damage compared with those without active lupus nephritis (adjusted hazard ratio = 1.52 (95% confidence interval (CI): 1.16, 1.97), p Conclusion Active lupus nephritis measured using the SLEDAI-2K domain cut-offs is associated with renal, but not non-renal, damage accrual in SLE.
- Published
- 2019
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