See the published version of this article at Arthritis Research & Therapy.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Comparison of complete renal response and mortality in early- and late-onset lupus nephritis: A multicenter retrospective study of a Japanese cohort
Kunihiro Ichinose
Nagasaki University Graduate School of Biomedical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8794-7106
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Arthritis Research & Therapy.
Background: Most patients with systemic lupus erythematosus (SLE) progress to lupus nephritis (LN) within 5 years of their SLE diagnosis, although it is not uncommon for LN to develop at later time points. Here we evaluated the clinical features of early- and late-onset LN.
Patients and Methods: We retrospectively analyzed the cases of 184 of the 201 patients who underwent a renal biopsy at Nagasaki University Hospital and associated community hospitals between 1990 and 2016 and were diagnosed as having LN. Early-onset was defined as the development of LN within the first 5 years after the patient's SLE diagnosis, and late-onset was defined as LN development >5 years post-diagnosis. We analyzed the complete renal response (CR) at 6 and 12 months after induction therapy, the classification of renal pathology, and the mortality of the early- and late-onset LN groups.
Results: The mean follow-up duration after renal biopsy was 123±85 months. There were 113 (61.4%) early-onset patients and 71 (38.6%) late-onset patients. A multivariate analysis revealed that the following factors were predictive of CR. At 6 months: female sex (odds ratio [OR] 4.64, 95% confidence interval [CI] 1.66–12.98, p=0.002), proteinuria (OR 0.82, 95%CI 0.70–0.95, p=0.003), index of activity (0–24) (OR 0.85, 95%CI 0.74–0.97, p=0.014), and early-onset LN (OR 2.26, 95%CI 1.11–4.58, p=0.023). At 12 months: female sex (OR 3.95, 95% CI 1.62–9.64, p=0.002), index of activity (0–24) (OR 0.80, 95%CI 0.71–0.91, p<0.001), and early-onset LN (OR 1.98, 95%CI 1.04–3.79, p=0.038). In a Cox proportional hazards model, the early-onset LN group had a significantly better mortality rate than the late-onset LN group (p=0.038).
Conclusions: In our cohort, early-onset LN was a better predictor of CR at 6 and 12 months. Our results suggest that early-onset LN patients had lower mortality than late-onset LN patients.
Keywords
complete renal response, lupus nephritis, early-onset, late-onset, systemic lupus erythematosus
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 13 Jun, 2020
Published
On 22 Jul, 2020
No community comments so far
Editor assigned
On 12 Jun, 2020
Reviewer #1 agreed
On 12 Jun, 2020
Reviewers invited
Invitations sent on 12 Jun, 2020
Submission checks complete
On 11 Jun, 2020
Editor invited
On 11 Jun, 2020
No comments provided
Editorial decision: Major revision
On 31 May, 2020
Review #1 received
Received 25 May, 2020
Reviewer #1 agreed
On 18 May, 2020
Editor assigned
On 14 May, 2020
Reviewers invited
Invitations sent on 14 May, 2020
First submitted
On 13 May, 2020
Submission checks complete
On 13 May, 2020
Editor invited
On 13 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Rheumatology
Learn more about our company.
This preprint is under consideration at Arthritis Research & Therapy. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Comparison of complete renal response and mortality in early- and late-onset lupus nephritis: A multicenter retrospective study of a Japanese cohort
Kunihiro Ichinose
Nagasaki University Graduate School of Biomedical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8794-7106
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 13 Jun, 2020
Published
On 22 Jul, 2020
No community comments so far
Editor assigned
On 12 Jun, 2020
Reviewer #1 agreed
On 12 Jun, 2020
Reviewers invited
Invitations sent on 12 Jun, 2020
Submission checks complete
On 11 Jun, 2020
Editor invited
On 11 Jun, 2020
No comments provided
Editorial decision: Major revision
On 31 May, 2020
Review #1 received
Received 25 May, 2020
Reviewer #1 agreed
On 18 May, 2020
Editor assigned
On 14 May, 2020
Reviewers invited
Invitations sent on 14 May, 2020
First submitted
On 13 May, 2020
Submission checks complete
On 13 May, 2020
Editor invited
On 13 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Rheumatology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Arthritis Research & Therapy.
Background: Most patients with systemic lupus erythematosus (SLE) progress to lupus nephritis (LN) within 5 years of their SLE diagnosis, although it is not uncommon for LN to develop at later time points. Here we evaluated the clinical features of early- and late-onset LN.
Patients and Methods: We retrospectively analyzed the cases of 184 of the 201 patients who underwent a renal biopsy at Nagasaki University Hospital and associated community hospitals between 1990 and 2016 and were diagnosed as having LN. Early-onset was defined as the development of LN within the first 5 years after the patient's SLE diagnosis, and late-onset was defined as LN development >5 years post-diagnosis. We analyzed the complete renal response (CR) at 6 and 12 months after induction therapy, the classification of renal pathology, and the mortality of the early- and late-onset LN groups.
Results: The mean follow-up duration after renal biopsy was 123±85 months. There were 113 (61.4%) early-onset patients and 71 (38.6%) late-onset patients. A multivariate analysis revealed that the following factors were predictive of CR. At 6 months: female sex (odds ratio [OR] 4.64, 95% confidence interval [CI] 1.66–12.98, p=0.002), proteinuria (OR 0.82, 95%CI 0.70–0.95, p=0.003), index of activity (0–24) (OR 0.85, 95%CI 0.74–0.97, p=0.014), and early-onset LN (OR 2.26, 95%CI 1.11–4.58, p=0.023). At 12 months: female sex (OR 3.95, 95% CI 1.62–9.64, p=0.002), index of activity (0–24) (OR 0.80, 95%CI 0.71–0.91, p<0.001), and early-onset LN (OR 1.98, 95%CI 1.04–3.79, p=0.038). In a Cox proportional hazards model, the early-onset LN group had a significantly better mortality rate than the late-onset LN group (p=0.038).
Conclusions: In our cohort, early-onset LN was a better predictor of CR at 6 and 12 months. Our results suggest that early-onset LN patients had lower mortality than late-onset LN patients.
Figure 1
Figure 2
Figure 3