Lupus & antiphospholipid syndrome
Can we predict kidney involvement in patients with systemic lupus erythematosus? A retrospective cohort study with independent validation
Authors' conclusion
Male sex, younger age and serological activity at SLE diagnosis are strongly associated with subsequent kidney involvement.
Study context
- Population
- Patients with SLE from the 'Attikon' Lupus cohort; validation in the University of Crete Lupus registryderivation cohort
- Participants
- 570 patients
- Exposure
- Baseline characteristics of patients with SLE who developed LN vs those who did not
- Outcome
- Incident LN, defined by kidney histology and/or classification criteria
Methodological detailsindependent validation cohort, multivariate Cox proportional hazards model
- Independent validation cohort
- Multivariate Cox proportional hazards model
Main finding
As reported in the abstract
Baseline predictors of subsequent LN (66 patients developing LN during follow-up)
Adjusted hazard ratio (95% CI)P value
Male sex
4.31(1.82–10.2)
Age of SLE diagnosis below 26 years
3.71(1.84–7.48)
High anti-dsDNA titre
2.48(1.03–5.97)
Low C3 and/or C4
2.24(0.83–6.05)
P = 0.11Combination of these factors at diagnosisvs Serologically inactive, older, female patientsalmost 90-fold risk; very high-risk group
88.77(18.75–420.41)
Observational data: associations, not effects.
Further findings
LN incidence (initial presentation plus during follow-up)
- LN as initial presentation
- 59
- LN developed during follow-up
- 66
- Collective incidence
- 21.9%
Independent validation in the Crete Lupus registry
- Concordant results with the original cohort
Original publication
Can we predict kidney involvement in patients with systemic lupus erythematosus? A retrospective cohort study with independent validation. Rheumatology (Oxford). Published 15 May 2024. doi:10.
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