Systemic lupus erythematosus in a multiethnic US cohort (LUMINA) XL II: factors predictive of new or worsening proteinuria
| Autor: | Jeffrey M. Roseman, Holly M. Bastian, Gerald McGwin, Luis M. Vilá, Graciela S. Alarcón, B. J. Fessler, John D. Reveille |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Lupus nephritis Severity of Illness Index White People Rheumatology Risk Factors Internal medicine Severity of illness medicine Humans Lupus Erythematosus Systemic Genetic Predisposition to Disease Pharmacology (medical) Systemic lupus erythematosus Lupus erythematosus Proteinuria biology business.industry Anti-dsDNA antibodies Age Factors DNA HLA-DR Antigens Hispanic or Latino Odds ratio Middle Aged medicine.disease Lupus Nephritis United States Black or African American Socioeconomic Factors Antibodies Antinuclear Cohort Immunology Disease Progression biology.protein Female medicine.symptom business HLA-DRB1 Chains |
| Zdroj: | Rheumatology. 46:683-689 |
| ISSN: | 1462-0332 1462-0324 |
| DOI: | 10.1093/rheumatology/kel347 |
| Popis: | OBJECTIVES To determine the factors predictive of new or worsening proteinuria in a large multiethnic cohort of patients with systemic lupus erythematosus (SLE). METHODS Five hundred and twenty-nine SLE patients from a multiethnic US cohort [LUpus in MInorities: NAture versus Nurture (LUMINA)] were evaluated for new or worsening proteinuria using the categories of the Systemic Lupus Activity Measure-Revised: (1), normal; (2), trace or 1+ proteinuria on the dipstick; (3), 2-3+ proteinuria and (4), > or =4+ proteinuria. A rise in urinary protein was considered a positive event visit. Basic demographic and socioeconomic variables were assessed at baseline (T0). Clinical and immunological variables including disease features, activity, duration, comorbidities (such as hypertension and diabetes), medications and autoantibodies were assessed at the visit preceding a positive event visit. Selected HLA-DR and HLA-DQ alleles, and FCGR receptor polymorphisms were assessed. Data were analysed using logistic regression analyses and generalized estimating equations. RESULTS There were 243 patients (59.1% of 93 Texan Hispanics, 37.0% of 100 Puerto Rican Hispanics, 58.0% of 181 African Americans and 29.7% of 155 Caucasians) with new or worsening proteinuria, and 364 positive events in 2801 visits. Younger age [Odds ratio (OR) = 1.013, 95% confidence limits (CL) = 1.001-1.024, P < 0.0334], anti-dsDNA (OR = 1.554, CL = 1.149-2.100, P < 0.0042), and HLA-DRB1*1503 (OR = 1.746, 95% CL = 1.573-2.2673, P < 0.0103) were found to independently predict the occurrence of new or worsening proteinuria. CONCLUSION The factors predictive of new or worsening proteinuria include traditional factors associated with lupus nephritis, such as age and anti-dsDNA, as well as HLA-DRB1*1503, which has not been previously described in association with lupus nephritis, new or worsening proteinuria. |
| Databáze: | OpenAIRE |
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