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Search: onr:"swepub:oai:lup.lub.lu.se:f248332f-3574-40b3-b269-84cc16daf82c" > A Longitudinal Anal...

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  • Hanly, John G.Dalhousie University (author)

A Longitudinal Analysis of Outcomes of Lupus Nephritis in an International Inception Cohort Using a Multistate Model Approach

  • Article/chapterEnglish2016

Publisher, publication year, extent ...

  • 2016-07-27
  • Wiley,2016
  • 13 s.

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:f248332f-3574-40b3-b269-84cc16daf82c
  • https://lup.lub.lu.se/record/f248332f-3574-40b3-b269-84cc16daf82cURI
  • https://doi.org/10.1002/art.39674DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:134219318URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Objective: To study bidirectional change and predictors of change in estimated glomerular filtration rate (GFR) and proteinuria in lupus nephritis (LN) using a multistate modeling approach. Methods: Patients in the Systemic Lupus International Collaborating Clinics inception cohort were classified annually into estimated GFR state 1 (>60 ml/minute), state 2 (30–60 ml/minute), or state 3 (3.0 gm/day), or end-stage renal disease (ESRD) or death. Using multistate modeling, relative transition rates between states indicated improvement and deterioration. Results: Of 1,826 lupus patients, 700 (38.3%) developed LN. During a mean ± SD follow-up of 5.2 ± 3.5 years, the likelihood of improvement in estimated GFR and estimated proteinuria was greater than the likelihood of deterioration. After 5 years, 62% of patients initially in estimated GFR state 3 and 11% of patients initially in estimated proteinuria state 3 transitioned to ESRD. The probability of remaining in the initial states 1, 2, and 3 was 85%, 11%, and 3%, respectively, for estimated GFR and 62%, 29%, and 4%, respectively, for estimated proteinuria. Male sex predicted improvement in estimated GFR states; older age, race/ethnicity, higher estimated proteinuria state, and higher renal biopsy chronicity scores predicted deterioration. For estimated proteinuria, race/ethnicity, earlier calendar years, damage scores without renal variables, and higher renal biopsy chronicity scores predicted deterioration; male sex, presence of lupus anticoagulant, class V nephritis, and mycophenolic acid use predicted less improvement. Conclusion: In LN, the expected improvement or deterioration in renal outcomes can be estimated by multistate modeling and is preceded by identifiable risk factors. New therapeutic interventions for LN should meet or exceed these expectations.

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  • Su, LiUniversity of Cambridge (author)
  • Urowitz, Murray B.University of Toronto (author)
  • Romero-Diaz, JuanitaInstituto Nacional de Ciencias Médicas y Nutrición (author)
  • Gordon, CarolineUniversity of Birmingham (author)
  • Bae, Sang CheolHanyang University (author)
  • Bernatsky, SashaMcGill University (author)
  • Clarke, Ann E.University of Calgary (author)
  • Wallace, Daniel J.Cedars-Sinai Medical Center (author)
  • Merrill, Joan T.Oklahoma Medical Research Foundation (author)
  • Isenberg, David A.Royal Free Hospital (author)
  • Rahman, AnisurRoyal Free Hospital (author)
  • Ginzler, Ellen M.SUNY Downstate Health Sciences University (author)
  • Petri, MichelleJohns Hopkins University School of Medicine (author)
  • Bruce, Ian N.University of Manchester (author)
  • Dooley, M. A.University of North Carolina (author)
  • Fortin, PaulLaval University (author)
  • Gladman, Dafna D.University of Toronto (author)
  • Sanchez-Guerrero, JorgeUniversity of Toronto (author)
  • Steinsson, KristjanNational University Hospital of Iceland (author)
  • Ramsey-Goldman, RosalindNorthwestern University (author)
  • Khamashta, Munther A.Guy's and St Thomas' NHS Foundation Trust (author)
  • Aranow, CynthiaFeinstein Institute for Medical Research (author)
  • Alarcón, Graciela S.University of Alabama (author)
  • Fessler, Barri J.University of Alabama (author)
  • Manzi, SusanUniversity of Pittsburgh (author)
  • Nived, OlaLund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)reum-oni (author)
  • Sturfelt, Gunnar K.Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)reum-gst (author)
  • Zoma, Asad A.Hairmyres Hospital (author)
  • van Vollenhoven, Ronald F.Karolinska Institutet,Karolinska Institute (author)
  • Ramos-Casals, ManuelHospital Clínic of Barcelona (author)
  • Ruiz-Irastorza, GuillermoUniversity of the Basque Country (author)
  • Lim, S. SamEmory University (author)
  • Kalunian, Kenneth C.University of California, San Diego (author)
  • Inanc, MuratIstanbul University (author)
  • Kamen, Diane L.Medical University of South Carolina (author)
  • Peschken, Christine A.University of Manitoba (author)
  • Jacobsen, SorenCopenhagen University Hospital (author)
  • Askanase, AncaIndian Institute of Technology (author)
  • Theriault, ChrisDalhousie University (author)
  • Farewell, VernonUniversity of Cambridge (author)
  • Dalhousie UniversityUniversity of Cambridge (creator_code:org_t)

Related titles

  • In:Arthritis & Rheumatology: Wiley68:8, s. 1932-19442326-51912326-5205

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