Renal relapse in children and adolescents with childhood-onset lupus nephritis: a 20-year study
Authors' conclusion
Renal relapse is common among cLN, especially among young patients, and is associated with an increased incidence of morbidity and mortality.
Study context
- Population
- Chinese patients with childhood-onset LN (cLN) diagnosed at ≤18 years, 2001–2021 (91% proliferative LN)
- Participants
- 95 Chinese cLN patients
- Exposure
- Renal relapse vs no renal relapse
- Renal relapsen = 39
- Outcome
- Incidence of renal relapse
Main finding
As reported in the abstract
Renal relapse incidence · follow-up of 10.2 years (s.d. 5.9)
- Renal relapses: 70 in 39 patients
- 0.07 episode/patient-year
- Relapse-free survival at 1 year
- 94.7
- Relapse-free survival at 2 years
- 86.0
- Relapse-free survival at 3 years
- 80.1
- Relapse-free survival at 4 years
- 71.2
- Relapse-free survival at 5 years
- 68.3
- Relapse-free survival at 10 years
- 50.3
- Relapse-free survival at 20 years
- 44.5%
Observational data: associations, not effects.
Further findings
Predictors of renal relapse (multivariate)
| aHR | P value | ||
|---|---|---|---|
| LN diagnosis <13.1 years | 2.59 (995% CI 1.27–5.29) | P = 0.01 | |
| AZA maintenance | 2.20 (95% CI 1.01–4.79) | P = 0.05 | |
| PR at 12 months | 3.9 (95% CI 1.03–9.19) | P = 0.01 | |
| Non-remission at 12 months | 3.08 (95% CI 1.35–11.3) | P = 0.04 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
Advanced CKD (stages 3-5) and end-stage kidney disease
P < 0.01
CR/PR rates · 12 months
- CR/PR
- 78.9%/7.4%
Safety
Infections
P = 0.02
Osteopenia
P = 0.04
Hypertension
P < 0.01
Original publication
Renal relapse in children and adolescents with childhood-onset lupus nephritis: a 20-year study. Rheumatology (Oxford). Published 26 August 2023. doi:10.
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