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Outcomes of membranous and proliferative lupus nephritis – analysis of a single-centre cohort with more than 30 years of follow-up

2020Journal article Open access
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dc.contributor.authorFarinha, Filipa
dc.contributor.authorPepper, Ruth J
dc.contributor.authorOliveira, Daniel G
dc.contributor.authorMcDonnell, Thomas
dc.contributor.authorIsenberg, David A
dc.contributor.authorRahman, Anisur
dc.date.accessioned2022-07-12T12:37:25Z
dc.date.available2022-07-12T12:37:25Z
dc.date.issued2020
dc.description.abstractObjectives: To compare membranous lupus nephritis (MLN) and proliferative lupus nephritis (PLN) with respect to survival, demographic, clinical and laboratory characteristics; and to investigate predictors of renal and patient survival. Methods: Single-centre retrospective observational study. Patients with biopsy-proven PLN, MLN and mixed lupus nephritis were included. Groups were compared using appropriate statistical tests and survival was analysed through the Kaplan-Meier method. Cox regression analysis was performed to investigate predictors of renal and patient survival. Results: A total of 187 patients with biopsy-proven lupus nephritis (135 with PLN, 38 with MLN and 14 with mixed LN) were followed for up to 42 years (median 12 years). There was a higher proportion of MLN amongst Afro-Caribbeans than amongst Caucasians (31% vs 15%, P = 0.010). Patients with MLN had significantly lower anti-dsDNA antibodies (P = 0.001) and higher C3 levels (P = 0.018) at diagnosis. Cumulative renal survival rates at 5, 10, 15 and 20 years were 91, 81, 75 and 66% for PLN and 100, 97, 92 and 84% for MLN, respectively (P = 0.028). Cumulative patient survival at 5, 10, 15 and 20 years was 94, 86, 80 and 76%, with no difference between PLN and MLN. Urinary protein-creatinine ratio above 42 mg/mmol and eGFR below 76 ml/min/1.73 m2, one year after the diagnosis of LN, were the strongest predictors of progression to end-stage renal disease. eGFR below 77 ml/min/1.73 m2, at one year, development of end-stage renal disease and Afro-Caribbean ethnicity were associated with higher mortality. Conclusion: Patients with MLN and PLN differ significantly regarding serological profiles and renal survival, suggesting different pathogenesis. Renal function at year one predicts renal and patient survival.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationFarinha F, Pepper RJ, Oliveira DG, McDonnell T, Isenberg DA, Rahman A. Outcomes of membranous and proliferative lupus nephritis - analysis of a single-centre cohort with more than 30 years of follow-up. Rheumatology (Oxford). 2020;59(11):3314-3323. doi:10.1093/rheumatology/keaa103pt_PT
dc.identifier.doi10.1093/rheumatology/keaa103pt_PT
dc.identifier.issn1462-0324
dc.identifier.issn1462-0332
dc.identifier.urihttp://hdl.handle.net/10400.16/2714
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxford University Presspt_PT
dc.relation.publisherversionhttps://academic.oup.com/rheumatology/article/59/11/3314/5821466?login=falsept_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectlupus nephritispt_PT
dc.subjectoutcomespt_PT
dc.subjectsurvivalpt_PT
dc.subjectSystemic lupus erythematosuspt_PT
dc.titleOutcomes of membranous and proliferative lupus nephritis – analysis of a single-centre cohort with more than 30 years of follow-uppt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceEnglandpt_PT
oaire.citation.endPage3323pt_PT
oaire.citation.issue11pt_PT
oaire.citation.startPage3314pt_PT
oaire.citation.titleRheumatologypt_PT
oaire.citation.volume59pt_PT
person.familyNameGuimarães Tato Ramos de Oliveira
person.givenNameDaniel Filipe
person.identifier.ciencia-id4C10-BF46-FD75
person.identifier.orcid0000-0002-3561-0250
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication8ed9ffd4-2be9-4808-a20c-1de926ad2257
relation.isAuthorOfPublication.latestForDiscovery8ed9ffd4-2be9-4808-a20c-1de926ad2257

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