Managing lupus nephritis

Cadet, Myriam Jean; Tucker, Lorna

doi:10.1097/01.npr.0000544280.27880.fe

Cited by 2 publications

(3 citation statements)

References 18 publications

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“…Guidelines about SLE focused on nursing tasks are still scarce. Existing international nursing guidelines are focused on lupus nephritis management, immunoglobulin administration, or chronic inflammatory arthritis (Bech et al, 2020;Cadet & Tucker, 2018;Gilman et al, 2019;Younger et al, 2013). In Spain, no national guides for nurses are available, and each center and service may have their own reference, which can differ greatly between hospitals, even in the same region.…”

Section: Discussionmentioning

confidence: 99%

“…In Spain, SLE is one of the most frequent autoimmune diseases, with a prevalence of 210/100,000 inhabitants (Cortés Verdú et al, 2020; Seoane-Mato et al, 2018). Prognosis of SLE has significantly improved recently (Hernández-Rodríguez et al, 2020); however, people with SLE have a mortality risk two to three times higher than the general population (Bernatsky et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

“…Effective disease management must involve comprehensive care through multidisciplinary units (Fanouriakis et al, 2019;Gordon et al, 2018;Hahn et al, 2012) where nurses are key agents due to their close contact with the patient and the extensive roles they perform throughout the care process (García et al, 2021;Gilman et al, 2019). Some international guidelines address specific aspects on the nurses' role during the management of people with SLE; however, specific nursing guidelines are still rare in Europe (Cadet & Tucker, 2018;Gilman et al, 2019;Younger et al, 2013), and a lack of specialized nurses in Rheumatology services in Spain has been recently reported (Urizar et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Nursing Recommendations in the Management of Systemic Lupus Erythematosus: A Delphi Consensus

García

Quesada

Vargas

et al. 2023

Hisp Health Care Int

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Introduction: Nurses’ role in the management of people with systemic lupus erythematosus (SLE) is essential. Specific guidelines for nurses have not been previously developed in Spain. This project aimed to try to develop comprehensive and validated recommendations for nurses regarding the management of people with SLE. Method: A Delphi questionnaire with 90 general and specific recommendations was designed by the scientific committee and underwent two rounds of participation. Results: Panellists reached a consensus on “agreement” for 85 recommendations during the first round and for 87 recommendations after the second and final rounds. Panellists agreed that people with SLE should be managed within a multidisciplinary team, and that this team should include specialized nurses. Panellists stated that most of the services lack specialized nurses. Experts identified lack of specific training programs targeted to nurses as the main barrier for application of recommendations. Panellists recommended an extended role for nurses in the management of people with SLE, including diagnosis, patient education, treatment monitoring and administration, and follow-up. Conclusions: This study is the first consensus that provides nursing recommendations from experts on the management of people with SLE in Europe. Design of standardized training programs targeted to nurses would facilitate the application of the recommendations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nursing Recommendations in the Management of Systemic Lupus Erythematosus: A Delphi Consensus

García

Quesada

Vargas

et al. 2023

Hisp Health Care Int

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Urinary markers differentially associate with kidney inflammatory activity and chronicity measures in patients with lupus nephritis

et al. 2023

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ObjectiveLupus nephritis (LN) is diagnosed by biopsy, but longitudinal monitoring assessment methods are needed. Here, in this preliminary and hypothesis-generating study, we evaluate the potential for using urine proteomics as a non-invasive method to monitor disease activity and damage. Urinary biomarkers were identified and used to develop two novel algorithms that were used to predict LN activity and chronicity.MethodsBaseline urine samples were collected for four cohorts (healthy donors (HDs, n=18), LN (n=42), SLE (n=17) or non-LN kidney disease biopsy control (n=9)), and over 1 year for patients with LN (n=42). Baseline kidney biopsies were available for the LN (n=46) and biopsy control groups (n=9). High-throughput proteomics platforms were used to identify urinary analytes ≥1.5 SD from HD means, which were subjected to stepwise, univariate and multivariate logistic regression modelling to develop predictive algorithms for National Institutes of Health Activity Index (NIH-AI)/National Institutes of Health Chronicity Index (NIH-CI) scores. Kidney biopsies were analysed for macrophage and neutrophil markers using immunohistochemistry (IHC).ResultsIn total, 112 urine analytes were identified from LN, SLE and biopsy control patients as both quantifiable and overexpressed compared with HDs. Regression analysis identified proteins associated with the NIH-AI (n=30) and NIH-CI (n=26), with four analytes common to both groups, demonstrating a difference in the mechanisms associated with NIH-AI and NIH-CI. Pathway analysis of the NIH-AI and NIH-CI analytes identified granulocyte-associated and macrophage-associated pathways, and the presence of these cells was confirmed by IHC in kidney biopsies. Four markers each for the NIH-AI and NIH-CI were identified and used in the predictive algorithms. The NIH-AI algorithm sensitivity and specificity were both 93% with a false-positive rate (FPR) of 7%. The NIH-CI algorithm sensitivity was 88%, specificity 96% and FPR 4%. The accuracy for both models was 93%.ConclusionsLongitudinal predictions suggested that patients with baseline NIH-AI scores of ≥8 were most sensitive to improvement over 6–12 months. Viable approaches such as this may enable the use of urine samples to monitor LN over time.

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Managing lupus nephritis

Cited by 2 publications

References 18 publications

Nursing Recommendations in the Management of Systemic Lupus Erythematosus: A Delphi Consensus

Nursing Recommendations in the Management of Systemic Lupus Erythematosus: A Delphi Consensus

Urinary markers differentially associate with kidney inflammatory activity and chronicity measures in patients with lupus nephritis

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