The pleomorphic nature of lupus nephritis has confounded efforts to refine estimates of prognosis.
Consideration of interactions among prognostic factors may help to identify high-risk patients.
By univariate and multivariate survival analysis, race and attributes of severe active lupus nephritis were evaluated as potentially important prognostic factors in 166 patients upon entry into prospective therapeutic trials of lupus kidney disease.
Black patients were significantly more likely than others to develop renal insufficiency.
Cellular crescents emerged as the most predictive active pathological feature and interstitial fibrosis was the strongest chronic histological prognostic factor.
Combinations of these morphological attributes identified particularly high-risk individuals.
Patients with 50% or more cellular crescents and those with less extensive cellular crescents plus moderate to severe interstitial fibrosis were at markedly increased risk for doubling serum creatinine compared to those who lacked these histologic features (P<0.0001).
Azotaemia, anaemia, hypocomplementaemia, hypertension, tubular atrophy and glomerular sclerosis were also associated with an increased probability of renal function deterioration.
Mots-clés Pascal : Lupus érythémateux, Disséminé, Homme, Néphropathie glomérulaire, Insuffisance rénale, Complication, Facteur risque, Pronostic, Epidémiologie, Race, Peau pathologie, Tissu conjonctif pathologie, Maladie système, Maladie autoimmune, Immunopathologie, Appareil urinaire pathologie, Rein pathologie, Facteur prédictif
Mots-clés Pascal anglais : Lupus erythematosus, Disseminated, Human, Glomerulonephritis, Renal failure, Complication, Risk factor, Prognosis, Epidemiology, Race, Skin disease, Connective tissue disease, Systemic disease, Autoimmune disease, Immunopathology, Urinary system disease, Renal disease, Predictive factor
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0553057
Code Inist : 002B14A01. Création : 01/03/1996.