Lupus nephritis is associated with more corticosteroid-associated organ damage but less corticosteroid non-associated organ damage
- Authors
- Joo, Young-bin; Won, Soyoung; Choi, Chan-beom; Bae, Sang-cheol
- Issue Date
- May-2017
- Publisher
- SAGE PUBLICATIONS LTD
- Keywords
- Systemic lupus erythematosus; lupus nephritis; organ damage; corticosteroid
- Citation
- LUPUS, v.26, no.6, pp.598 - 605
- Indexed
- SCIE
SCOPUS
- Journal Title
- LUPUS
- Volume
- 26
- Number
- 6
- Start Page
- 598
- End Page
- 605
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/3542
- DOI
- 10.1177/0961203316671813
- ISSN
- 0961-2033
- Abstract
- Objective
The objective of this study was to investigate the association of lupus nephritis on organ damage and mortality in patients with systemic lupus erythematosus (SLE).
Methods
A total of 1112 patients with SLE were investigated. Lupus nephritis was defined as a proteinuria based on the 1997 American College of Rheumatology criteria. Damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. The associations of lupus nephritis with overall, non-renal, corticosteroid-associated, and non-associated damage were analyzed using logistic regression. The age-adjusted and sex-adjusted standardized mortality ratio was evaluated in patients with and without lupus nephritis.
Results
The prevalence of lupus nephritis in patients with SLE was 46.3%. Patients with lupus nephritis had a higher percentage of overall cumulative damage than patients without lupus nephritis (51.5% vs. 35.7%, p < 0.001). The odds ratio was 1.40 after adjusting for age at SLE diagnosis, sex, disease duration, anti-malarial agents, immunosuppressive agents and cumulative corticosteroid dose. Among non-renal damage, the odds of corticosteroid-associated damage were higher (2.06, 95% confidence interval (CI) 1.43–2.96) whereas the odds of non-associated damage were lower (0.50, 95% CI 0.35–0.75) in patients with lupus nephritis. The standardized mortality ratios of patients with and without lupus nephritis were 5.17 (95% CI 3.49–7.38) and 2.32 (95% CI 1.47–3.48), respectively.
Conclusion
In patients with SLE, the presence of lupus nephritis is associated with increased corticosteroid-associated damage but less corticosteroid non-associated damage. Also, mortality is significantly higher in patients with lupus nephritis than in those without lupus nephritis.
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