Clinical and Genetic Risk Factors Associated With the Presence of Lupus Nephritis

Abstract

Objective. To elucidate whether clinical features and the weighted genetic risk score (wGRS) were associated with the presence of lupus nephritis (LN). Methods. We retrospectively divided patients with systemic lupus erythematosus (SLE, n=1,078) into biopsy-proven LN (n=507) and non-LN groups (non-LN, n=571). Baseline clinical features, serologic markers, and the wGRS were collected. The wGRS was calculated from 112 non-human leukocyte antigen (non-HLA) loci and HLA-DRβ1 amino acid haplotypes for SLE. Associations among clinical features, wGRS, and the presence of LN were identified. Results. In the multivariate analysis, patients with LN were younger at diagnosis (odds ratio [OR]=0.97, p＜0.001), had more pleuritis (OR=2.44, p＜0.001) and pericarditis (OR=1.62, p=0.029), had a higher detection rate of anti-double stranded deoxyribonucleic acid (anti-dsDNA antibodies, OR=2.22, p＜0.001), anti-Smith antibodies (anti-Sm antibodies, OR=1.70, p=0.002), low level of complement (OR=1.37, p=0.043) and absence of antiphospholipid antibodies (aPL antibodies, OR=1.60, p=0.002), and had higher wGRS (OR=1.16, p=0.012). Mediation analysis suggested that anti-Sm antibodies and low complement could be mediators in the relationship between high wGRS and the presence of LN. Conclusion. Onset age, pleuritis, pericarditis, several serologic markers, and wGRS were associated with the presence of LN. Anti-Sm antibodies and low complement appeared to mediate the indirect relationship between wGRS and the presence of LN.

Comparative Efficacy and Safety of Biological Agents in the Treatment of Lupus Nephritis: A Network Meta-Analysis

“…Usage, derivative works and distribution are permitted provided that proper credit is given to the author and the original publisher. Lee death in SLE [2,3]. In a 10-year follow-up, 20% of patients with lupus nephritis developed end-stage renal disease [4].…”

“…Systemic lupus erythematosus (SLE) is a systemic autoimmunity disorder with an unclear cause characterized by severe inflammation and organ damage [ 1 ]. Renal involvement occurs in up to 60% of patients with SLE, and lupus nephritis is still the leading cause of morbidity and death in SLE [ 2 , 3 ]. In a 10-year follow-up, 20% of patients with lupus nephritis developed end-stage renal disease [ 4 ].…”

Direct oral anticoagulants versus warfarin in patients with antiphospholipid syndrome: A meta-analysis of randomized controlled trials

“…Although we took care to pool data from only reasonably homogeneous trials, statistical heterogeneity in outcome analyses, as well as the unavoidable clinical and methodological heterogeneity, may have influenced our findings. 29 Third, we could not confirm that in the five studies they refer to all of the patients were tested for all three kinds of antiphospholipid antibody, because only one study described that they tested all three kinds of antiphospholipid antibody. 12 We also cannot tell whether one of the three kinds of phospholipid antibodies was more likely to be associated with an increased risk in either arterial or venous thrombosis, because there were no such data in the five studies.…”

Multitarget therapy versus monotherapy as induction treatment for lupus nephritis: A meta-analysis of randomized controlled trials

“…Renal involvement affects up to 60% of individuals with systemic lupus erythematosus (SLEs), in whom lupus nephritis (LNs) remains the leading cause of morbidity and mortality. 1 In one study, at the 10 years follow-up, 20% of individuals with LN developed the end-stage renal disease. 2 Proliferative disease (World Health Organization classes III and IV) is a severe illness that requires extensive therapy to achieve remission and avoid considerable renal mortality.…”