The ISN/RPS 2016 classification predicts renal prognosis in patients with first-onset class III/IV lupus nephritis
| Autor: | Naotake Tsuboi, Takuji Ishimoto, Shoichi Maruyama, Asaka Hachiya, Noritoshi Kato, Tomoki Kosugi, Munetoshi Karasawa, Takayuki Katsuno, Takahiro Imaizumi |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Science Kidney Glomerulus Remission Spontaneous 030232 urology & nephrology Lupus nephritis Renal function Kidney Severity of Illness Index Gastroenterology Article Cohort Studies 03 medical and health sciences chemistry.chemical_compound Rheumatic diseases 0302 clinical medicine Internal medicine Humans Lupus Erythematosus Systemic Medicine Renal Insufficiency Pathological Hyaline Proportional Hazards Models Retrospective Studies 030203 arthritis & rheumatology Creatinine Multidisciplinary business.industry Proportional hazards model Remission Induction Middle Aged Prognosis medicine.disease Lupus Nephritis chemistry Female business Complication Glomerular Filtration Rate Cohort study |
| Zdroj: | Scientific Reports, Vol 11, Iss 1, Pp 1-12 (2021) Scientific Reports |
| ISSN: | 2045-2322 |
| Popis: | Lupus nephritis (LN) is a life-threatening complication of systemic lupus erythematosus. The 2003 pathological classification of LN was revised in 2016; it quantitatively evaluates the interstitium in addition to the glomeruli. We performed a retrospective multi-centre cohort study and investigated the utility of the 2016 classification—including the activity index (AI), chronicity index (CI), and each pathological component to predict complete remission or renal function decline, defined as 1.5-fold increase in serum creatinine levels—and compare with that of the 2003 classification. Ninety-one consecutive adult patients with first-onset class III/IV LN who were newly prescribed any immunosuppressants were enrolled and followed up for a median of 51 months from January 2004. Cox regression analysis demonstrated the subclasses based on the 2003 classification, which mainly evaluate glomerular lesions, were not associated with clinical outcomes. After adjustments for estimated glomerular filtration rate and urinary protein levels, higher CI and higher interstitial fibrosis and lower hyaline deposit scores were associated with renal functional decline. Similarly, higher CI and interstitial inflammation scores were associated with failure to achieve complete remission. Therefore, the 2016 classification can predict the clinical outcomes more precisely than the 2003 classification. |
| Databáze: | OpenAIRE |
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