Lupus nephritis in Chinese children – a territory-wide cohort study in Hong Kong

Wong, Sik-Nin; Tse, Kei-Chiu; Lee, Tsz-Leung; Lee, Kwok-Wai; Chim, Stephen S.C.; Lee, Kwok-Piu; Chu, Reann Wai-Po; Chan, Winnie Kwai-Yu; Fong, Kwok-Wah; Hui, Joannie; Li, Samantha Po-Siu; Yeung, Pa-Shing; Yuen, So-Fun; Ho, A.; Leung, Lettie Chuk-Kwan; Luk, David C K; Tong, Pak-chiu; Chan, S. C. W.; Cheung, Hon-Ming; Chow, Chung-Mo; Lau, David C.W.

doi:10.1007/s00467-006-0052-3

Cited by 55 publications

(53 citation statements)

References 27 publications

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“…This might reflect the less percent of glomeruli with crescents and those with global sclerosis in the LN group. Similar good renal outcome was reported by others [10–12] (Table 8). In one study, [10] none of the children with lupus nephritis required dialysis which is similar to our finding (Table 8).…”

Section: Discussionsupporting

confidence: 90%

Glomerulonephritis with Crescents in Children: Etiology and Predictors of Renal Outcome

et al. 2011

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Objective. To investigate the clinicopathological features and outcome of glomerulonephritis with crescents among Saudi children. Method. This is a retrospective study of cases of crescentic glomerulonephritis (CrGN) seen over a 9-year period. Histological features and renal function were recorded. Results. Thirty-seven cases were enrolled. The mean percent of glomeruli with crescents was 39% (±19). Lupus nephritis (LN) was the commonest etiology (54.1%). At presentation, the serum creatinine (SCr) was 218.2 (±174.3) umol/l, and 57.1% of the cases had nephrotic range proteinuria. By the end of the observation period, SCr dropped to 81.0 (±67.7) umol/l (P = 0.001). Worsening renal function was associated with younger age (P = 0.002), non-LN etiology (P = 0.01), more crescents (P = 0.019), and ATN (P = 0.05). At the end of the followup, more patients in the LN group were dialysis-free (P = 0.017) and had improved renal function (0.01) than in the non-LN group. Using multivariate analysis, the only independent factor found to predict need for dialysis or change in SCr level was percent of globally sclerosed glomeruli (P = 0.034). Conclusion. LN is the main cause of CrGN in our cohort of children. The LN group had less globally sclerorsed glomeruli and better renal prognosis than the non-LN group.

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Section: Discussionsupporting

confidence: 90%

Glomerulonephritis with Crescents in Children: Etiology and Predictors of Renal Outcome

et al. 2011

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“…Septicemia occurring on a background of ESRD or otherwise was the commonest cause of death (75%). Other previous Indian studies and studies from other developing countries (Table 4) have also reported a similar trend wherein most children with lupus nephritis succumbed to serious infections (11,18,(31)(32)(33)(34).…”

Section: Discussionsupporting

confidence: 72%

Childhood lupus nephritis: 12 years of experience from a developing country’s perspective

Samanta¹,

Nandi²,

Mondal³

et al. 2017

Eur J Rheumatol

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Objective: To assess the long-term outcome of lupus nephritis in children with systemic lupus erythematosus followed up over 12 years at a tertiary care teaching hospital in Eastern India. Material and Methods:This is a retrospective observational study of the clinicopathological presentation, management, and outcome in 46 children with lupus nephritis over a period of 12 years at a tertiary teaching hospital in Eastern India. Mortality was compared between different lupus classes and therapy groups with Kaplan-Meier analysis and log-rank testResults: The incidence of lupus nephritis was 58.97% [95% confidence interval (CI) 48.06%-59.89%] with the mean age at presentation being 10.2±2.43 years (range 5.5-14.5) years. Majority belonged to class IV (30.43%), followed by class II (26.91%), class III (23.91), and class V (8.70%). Outcome analysis of children with lupus nephritis over 12 years revealed that 24 (52.17%) achieved complete remission of disease activity, 5 attained partial remission, 4 continued to have active disease, 5 developed end-stage renal disease (ESRD), and 8 died. Overall mortality thus observed was 17.39% with septicemia in the background of ESRD being the commonest cause. No significant difference in mortality was observed between different lupus nephritis classes or therapy arm groups. Conclusion:The study throws light on various aspects of lupus nephritis and their long-term outcome patterns in children from developing countries such as India.

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“…Lupus nephritis (LN) is one of the most severe complications, drastically increasing the morbidity and mortality of SLE patients 6 , with up to 60% of adult and 80% of pediatric SLE cases developing renal abnormalities during the course of the disease 7; 8 . The incidence of LN is higher in AA, HI and AS compared to populations of European ancestry: one study showed that incidences of renal disease for AA and HI are 68.9% and 60.6% respectively compared to EA (29.1%) after 5.5 years of follow-up 9 ; a similar elevated incidence in AS has also been confirmed 10;11 .…”

Section: Introductionmentioning

confidence: 94%

Role of MYH9 and APOL1 in African and non-African populations with lupus nephritis

et al. 2011

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Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by autoantibody production and organ damage. Lupus nephritis (LN) is one of the most severe manifestations of SLE. Multiple studies reported associations between renal diseases and variants in the non-muscle myosin heavy chain 9 (MYH9) and the neighboring apolipoprotein L 1 (APOL1) genes. We evaluated 167 variants spanning MYH9 for association with LN in a multiethnic sample. The two previously identified risk variants in APOL1 were also tested for association with LN in European-Americans (EAs) (N = 579) and African-Americans (AAs) (N = 407). Multiple peaks of association exceeding a Bonferroni corrected p-value of p < 2.03 × 10−3 were observed between LN and MYH9 in EAs (N=4620), with the most pronounced association at rs2157257 (p = 4.7 × 10−4; odds ratio [OR]=1.205). A modest effect with MYH9 was also detected in Gullah (rs8136069, p = 0.0019, OR = 2.304). No association between LN and MYH9 was found in AAs, Asians, Amerindians or Hispanics. This study provides the first investigation of MYH9 in LN in non-Africans and of APOL1 in LN in any population and presents novel insight into the potential role of MYH9 in LN in EAs.

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Lupus nephritis in Chinese children – a territory-wide cohort study in Hong Kong

Cited by 55 publications

References 27 publications

Glomerulonephritis with Crescents in Children: Etiology and Predictors of Renal Outcome

Glomerulonephritis with Crescents in Children: Etiology and Predictors of Renal Outcome

Childhood lupus nephritis: 12 years of experience from a developing country’s perspective

Role of MYH9 and APOL1 in African and non-African populations with lupus nephritis

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