International cohort of 382 children with lupus nephritis – presentation, treatment and outcome at 24 months.
Background: Children with lupus have a higher chance of nephritis and worse kidney outcome than adult patients. Methods: We retrospectively analyzed clinical presentation, treatment and 24-month kidney outcome in a cohort of 382 patients (≤ 18 years old) with lupus nephritis (LN) class ≥ III diagnos...
| Publicado en: | Pediatric Nephrology Vol. 38; no. 11; pp. 3699 - 3710 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Nov2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=172285021&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 172285021 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Nov2023 vid: 38 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 172285021 163865054 172285021 172285021 10.1007/s00467-023-06018-5 172285021 ppf: 3699 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: International cohort of 382 children with lupus nephritis – presentation, treatment and outcome at 24 months. aug: au: De Mutiis, Chiara Wenderfer, Scott E. Basu, Biswanath Bagga, Arvind Orjuela, Alvaro Sar, Tanmoy Aggarwal, Amita Jain, Avinash Yap, Hui-Kim Teo, Sharon Ito, Shuichi Ohnishi, Ai Iwata, Naomi Kasapcopur, Ozgur Yildiz, Mehmet Laurent, Audrey Mastrangelo, Antonio Ogura, Masao Shima, Yuko Rianthavorn, Pornpimol affil: Paediatric Unit, Maggiore Hospital, Azienda USL, Bologna, Italy sug: subj: Lupus Nephritis Symptoms Lupus Nephritis Therapy Treatment Outcomes Human Retrospective Design Record Review Child Age of Onset Male Female Disease Remission Age Factors Descriptive Statistics Lupus Nephritis Diagnosis Kidney Physiology Child: 6-12 years Male Female ab: Background: Children with lupus have a higher chance of nephritis and worse kidney outcome than adult patients. Methods: We retrospectively analyzed clinical presentation, treatment and 24-month kidney outcome in a cohort of 382 patients (≤ 18 years old) with lupus nephritis (LN) class ≥ III diagnosed and treated in the last 10 years in 23 international centers. Results: The mean age at onset was 11 years 9 months and 72.8% were females. Fifty-seven percent and 34% achieved complete and partial remission at 24-month follow-up, respectively. Patients with LN class III achieved complete remission more often than those with classes IV or V (mixed and pure). Only 89 of 351 patients maintained stable complete kidney remission from the 6th to 24th months of follow-up. eGFR ≥ 90 ml/min/1.73 m2 at diagnosis and biopsy class III were predictive of stable kidney remission. The youngest and the oldest age quartiles (2y—9y, 5m) (14y, 2m—18y,2m) showed lower rates of stable remission (17% and 20.7%, respectively) compared to the two other age groups (29.9% and 33.7%), while there was no difference in gender. No difference in achieving stable remission was found between children who received mycophenolate or cyclophosphamide as induction treatment. Conclusion: Our data show that the rate of complete remission in patients with LN is still not high enough. Severe kidney involvement at diagnosis was the most important risk factor for not achieving stable remission while different induction treatments did not impact outcome. Randomized treatment trials involving children and adolescents with LN are needed to improve outcome for these children. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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