Development of clinical and laboratory biomarkers in an international cohort of 428 children with lupus nephritis.

Autor: De Mutiis C; Paediatric Unit, Maggiore Hospital, Azienda USL, Bologna, Italy. chiarademutiis@yahoo.com., Wenderfer SE; Pediatric Nephrology, The University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada., Basu B; Division of Pediatric Nephrology, Department of Pediatrics, Nilratan Sircar Medical College and Hospital, Kolkata, India., Bagga A; Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India., Orjuela A; Pediatric Nephrology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA., Sar T; Division of Pediatric Nephrology, Department of Pediatrics, Nilratan Sircar Medical College and Hospital, Kolkata, India., Aggarwal A; Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India., Jain A; Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.; Department of Clinical Immunology and Rheumatology, Sawai Mansingh Medical College, Jaipur, India., Boyer O; Pediatric Nephrology, Necker Enfants Malades Hospital, Université Paris Cité, Paris, France.; Néphrologie Pédiatrique, Hôpital Necker, Paris, France., Yap HK; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Ito S; Department of Pediatrics, Yokohama City University, Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, Japan., Ohnishi A; Department of Pediatrics, Yokohama City University, Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, Japan., Iwata N; Department of Infection and Immunology, Aichi Children's Health and Medical Center, Obu, Japan., Kasapcopur O; Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey., Laurent A; Department of Pediatric Nephrology, Rheumatology and Dermatology, Hospices Civils de Lyon, Lyon, France., Chan EY; Paediatric Nephrology Centre, Hong Kong Children's Hospital, Kowloon, Hong Kong SAR.; Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR., Mastrangelo A; Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy., Ogura M; Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan., Shima Y; Department of Pediatrics, Wakayama Medical University, Wakayama, Japan., Rianthavorn P; Division of Nephrology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand., Silva CA; Pediatric Rheumatology Unit, Children's Institute, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil., Trindade V; Pediatric Rheumatology Unit, Children's Institute, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil., Tullus K; Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2024 Oct; Vol. 39 (10), pp. 2959-2968. Date of Electronic Publication: 2024 May 28.
DOI: 10.1007/s00467-024-06405-6
Abstrakt: Background: Lupus nephritis (LN) is a very severe manifestation of lupus. There is no consensus on which treatment goals should be achieved to protect kidney function in children with LN.
Methods: We retrospectively analyzed trends of commonly used laboratory biomarkers of 428 patients (≤ 18 years old) with biopsy-proven LN class ≥ III. We compared data of patients who developed stable kidney remission from 6 to 24 months with those who did not.
Results: Twenty-five percent of patients maintained kidney stable remission while 75% did not. More patients with stable kidney remission showed normal hemoglobin and erythrocyte sedimentation rate from 6 to 24 months compared to the group without stable kidney remission. eGFR ≥ 90 ml/min/1.73m 2 at onset predicted the development of stable kidney remission (93.8%) compared to 64.7% in those without stable remission (P < 0.00001). At diagnosis, 5.9% and 20.2% of the patients showed no proteinuria in the group with and without stable kidney remission, respectively (P = 0.0001). dsDNA antibodies decreased from onset of treatment mainly during the first 3 months in all groups, but more than 50% of all patients in both groups never normalized after 6 months. Complement C3 and C4 increased mainly in the first 3 months in all patients without any significant difference.
Conclusions: Normal eGFR and the absence of proteinuria at onset were predictors of stable kidney remission. Significantly more children showed normal levels of Hb and erythrocyte sedimentation rate (ESR) from 6 to 24 months in the group with stable kidney remission.
(© 2024. The Author(s), under exclusive licence to International Pediatric Nephrology Association.)
Databáze: MEDLINE
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