Analysis of clinical risk factors in relapsed patients with class IV lupus nephritis

Abstract

The present study aimed to investigate risk factors for renal recurrence in patients with type IV lupus nephritis (LN). Univariate and multivariate analyses were conducted to using the Cox proportional hazard model and the Kaplan-Meier method. A total 244 patients were diagnosed with type IV LN; 100 (28.49%) relapsed and 144 (41.03%) recovered successfully. Kaplan-Meier method analysis indicated that patients with type IV LN affecting the digestive tract had high renal recurrence rates. Patients with hyperglobulinemia, positive anti-ribonucleoprotein and anti-Sjögren's syndrome type B (anti-SSB) antibodies, thrombus in the loop or non-inflammatory necrotizing vasculopathy also had a high recurrence rate. Furthermore, patients achieving partial remission had an increased recurrence rate compared with patients achieving complete remission. Patients undergoing maintenance treatment with glucocorticoids alone had a higher recurrence rate compared with patients who used alternative treatment schemes. Univariate and multivariate regression analyses by the Cox proportional hazard model determined that the effect of systemic lupus erythematosus in the gastrointestinal tract, increased serum globulin levels and positive anti-SSB antibody at onset were risk factors for the recurrence of LN type IV. The present study demonstrated that clinical risk factors of renal recurrence in patients with LN type IV include LN in the gastrointestinal tract, increased serum globulin levels, positive anti-SSB antibodies at onset and the use of glucocorticoid-only maintenance treatment.

Autoantibodies spectrum in lupus nephritis in a cohort of Egyptian patients: relation to disease activity and prognostic value

“…Anti-dsDNA is playing an important role in the initial events involved in the pathogenesis of the disease [32]. Nawata et al and Wang et al reported that high titer of anti-dsDNA is associated with hematuria, proteinuria, elevated serum creatinine, nephrotic syndrome, and hypertension [42,43]. Rasten et al reported that anti-dsDNA significantly increased in male patients with lupus nephritis [44].…”

Factors Associated With Renal Involvement in Primary Sjögren's Syndrome: A Meta-Analysis

“…For these pSS patients with RTA, the test of the anti-SSB antibody showed more positive results (3) and the titer of the anti-SSB antibody was higher than that in those without (20). Furthermore, in other autoimmune diseases such as systemic lupus erythematosus (SLE), the positive anti-SSB antibody test was identified to be one of the risk factors for renal recurrence in those with lupus nephritis type IV (21). Meanwhile, it was also observed to have a connection with nodal or spleen enlargement and with an increased level of gamma-globulins in SS, SLE, and progressive systemic sclerosis (22).…”