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A Longitudinal Anal...
A Longitudinal Analysis of Outcomes of Lupus Nephritis in an International Inception Cohort Using a Multistate Model Approach
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- Hanly, John G. (author)
- Dalhousie University
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- Su, Li (author)
- University of Cambridge
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- Urowitz, Murray B. (author)
- University of Toronto
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- Romero-Diaz, Juanita (author)
- Instituto Nacional de Ciencias Médicas y Nutrición
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- Gordon, Caroline (author)
- University of Birmingham
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- Bae, Sang Cheol (author)
- Hanyang University
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- Bernatsky, Sasha (author)
- McGill University
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- Clarke, Ann E. (author)
- University of Calgary
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- Wallace, Daniel J. (author)
- Cedars-Sinai Medical Center
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- Merrill, Joan T. (author)
- Oklahoma Medical Research Foundation
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- Isenberg, David A. (author)
- Royal Free Hospital
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- Rahman, Anisur (author)
- Royal Free Hospital
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- Ginzler, Ellen M. (author)
- SUNY Downstate Health Sciences University
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- Petri, Michelle (author)
- Johns Hopkins University School of Medicine
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- Bruce, Ian N. (author)
- University of Manchester
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- Dooley, M. A. (author)
- University of North Carolina
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- Fortin, Paul (author)
- Laval University
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- Gladman, Dafna D. (author)
- University of Toronto
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- Sanchez-Guerrero, Jorge (author)
- University of Toronto
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- Steinsson, Kristjan (author)
- National University Hospital of Iceland
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- Ramsey-Goldman, Rosalind (author)
- Northwestern University
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- Khamashta, Munther A. (author)
- Guy's and St Thomas' NHS Foundation Trust
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- Aranow, Cynthia (author)
- Feinstein Institute for Medical Research
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- Alarcón, Graciela S. (author)
- University of Alabama
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- Fessler, Barri J. (author)
- University of Alabama
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- Manzi, Susan (author)
- University of Pittsburgh
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- Nived, Ola (author)
- 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
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- Sturfelt, Gunnar K. (author)
- 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
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- Zoma, Asad A. (author)
- Hairmyres Hospital
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- van Vollenhoven, Ronald F. (author)
- Karolinska Institutet,Karolinska Institute
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- Ramos-Casals, Manuel (author)
- Hospital Clínic of Barcelona
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- Ruiz-Irastorza, Guillermo (author)
- University of the Basque Country
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- Lim, S. Sam (author)
- Emory University
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- Kalunian, Kenneth C. (author)
- University of California, San Diego
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- Inanc, Murat (author)
- Istanbul University
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- Kamen, Diane L. (author)
- Medical University of South Carolina
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- Peschken, Christine A. (author)
- University of Manitoba
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- Jacobsen, Soren (author)
- Copenhagen University Hospital
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- Askanase, Anca (author)
- Indian Institute of Technology
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- Theriault, Chris (author)
- Dalhousie University
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- Farewell, Vernon (author)
- University of Cambridge
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(creator_code:org_t)
- 2016-07-27
- 2016
- English 13 s.
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In: Arthritis & Rheumatology. - : Wiley. - 2326-5191 .- 2326-5205. ; 68:8, s. 1932-1944
- Related links:
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http://dx.doi.org/10...
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https://europepmc.or...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
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- art (subject category)
- ref (subject category)
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- By the author/editor
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Hanly, John G.
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Su, Li
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Urowitz, Murray ...
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Romero-Diaz, Jua ...
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Gordon, Caroline
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Bae, Sang Cheol
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show more...
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Bernatsky, Sasha
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Clarke, Ann E.
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Wallace, Daniel ...
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Merrill, Joan T.
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Isenberg, David ...
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Rahman, Anisur
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Ginzler, Ellen M ...
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Petri, Michelle
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Bruce, Ian N.
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Dooley, M. A.
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Fortin, Paul
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Gladman, Dafna D ...
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Sanchez-Guerrero ...
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Steinsson, Krist ...
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Ramsey-Goldman, ...
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Khamashta, Munth ...
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Aranow, Cynthia
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Alarcón, Graciel ...
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Fessler, Barri J ...
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Manzi, Susan
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Nived, Ola
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Sturfelt, Gunnar ...
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Zoma, Asad A.
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van Vollenhoven, ...
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Ramos-Casals, Ma ...
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Ruiz-Irastorza, ...
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Lim, S. Sam
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Kalunian, Kennet ...
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Inanc, Murat
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Kamen, Diane L.
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Peschken, Christ ...
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Jacobsen, Soren
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Askanase, Anca
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Theriault, Chris
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Farewell, Vernon
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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Arthritis & Rheu ...
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Lund University
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Karolinska Institutet