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Conference Paper: Clinical Characteristics and outcomes of lupus nephritis patients with kidney biopsy showing thrombotic microangiopathy

TitleClinical Characteristics and outcomes of lupus nephritis patients with kidney biopsy showing thrombotic microangiopathy
Authors
Issue Date2018
PublisherEuropean Renal Association & European Dialysis and Transplant Association.
Citation
55th European Renal Association & European Dialysis and Transplant Association Congress (ERA-EDTA 2018), Copenhagen, Denmark, 24-27 May 2018 How to Cite?
AbstractINTRODUCTION AND AIMS: Renal thrombotic microangiopathy (TMA) is an uncommon pathological finding in lupus nephritis (LN), and its clinical significance remains to be established. METHODS: We retrospectively reviewed 677 patients with kidney biopsy showing lupus nephritis (LN), followed at Queen Mary Hospital, Hong Kong or Peking Union Medical College Hospital, China. Patients with renal TMA and those without renal TMA (Controls, matched according to demographics and treatment, in 1:2 ratio) were compared focusing on clinical features and outcome. RESULTS: Twenty-four patients (3.5%) with renal TMA and 48 Controls were included, with follow-up of 48.6±31.5 and 49.2±23.8 months respectively from the time of kidney biopsy. TMA patients showed a higher rate of anti-Ro seropositivity (45.8% vs. 18.8%, p=0.016), higher SLEDAI scores (21.4±8.5 vs. 10.8±2.0, p<0.001), worse eGFR (16.8±11.7 ml/min vs. 77.8±28.6 ml/min, p<0.001), and a higher proportion requiring dialysis (37.5% vs. 2.1%, p<0.001) at presentation. Activity and chronicity indices [median (range)] were higher in the TMA group - 11 (2-19) and 3(1-8) respectively, compared with 7 (0-15) and 1 (0-3) in Controls, p=0.004 and <0.001. TMA group showed inferior renal survival, higher incidence of chronic kidney disease, and lower median eGFR at last follow-up (5-year renal survival 70%, 66.6% CKD at last follow-up, median eGFR 50.1 ml/min with IQR 7-132 ml/min) compared with Controls (95%, 29.2%, and 85.0 ml/min with IQR 12-147 ml/min; p=0.023, 0.002 and 0.003 respectively). There was no difference in patient survival between the two groups (p=0.127). CONCLUSIONS: Renal biopsy showing TMA was associated with more severe renal impairment at presentation and worse long-term renal outcome in LN.
DescriptionPoster Presentation - Category: I - Glomerulonephritis - no. FP165
Persistent Identifierhttp://hdl.handle.net/10722/260762

 

DC FieldValueLanguage
dc.contributor.authorLi, C-
dc.contributor.authorYap, YHD-
dc.contributor.authorTang, CSO-
dc.contributor.authorWen, Y-
dc.contributor.authorLi, H-
dc.contributor.authorChan, G-
dc.contributor.authorLi, XM-
dc.contributor.authorLi, XW-
dc.contributor.authorChan, DTM-
dc.date.accessioned2018-09-14T08:46:57Z-
dc.date.available2018-09-14T08:46:57Z-
dc.date.issued2018-
dc.identifier.citation55th European Renal Association & European Dialysis and Transplant Association Congress (ERA-EDTA 2018), Copenhagen, Denmark, 24-27 May 2018-
dc.identifier.urihttp://hdl.handle.net/10722/260762-
dc.descriptionPoster Presentation - Category: I - Glomerulonephritis - no. FP165-
dc.description.abstractINTRODUCTION AND AIMS: Renal thrombotic microangiopathy (TMA) is an uncommon pathological finding in lupus nephritis (LN), and its clinical significance remains to be established. METHODS: We retrospectively reviewed 677 patients with kidney biopsy showing lupus nephritis (LN), followed at Queen Mary Hospital, Hong Kong or Peking Union Medical College Hospital, China. Patients with renal TMA and those without renal TMA (Controls, matched according to demographics and treatment, in 1:2 ratio) were compared focusing on clinical features and outcome. RESULTS: Twenty-four patients (3.5%) with renal TMA and 48 Controls were included, with follow-up of 48.6±31.5 and 49.2±23.8 months respectively from the time of kidney biopsy. TMA patients showed a higher rate of anti-Ro seropositivity (45.8% vs. 18.8%, p=0.016), higher SLEDAI scores (21.4±8.5 vs. 10.8±2.0, p<0.001), worse eGFR (16.8±11.7 ml/min vs. 77.8±28.6 ml/min, p<0.001), and a higher proportion requiring dialysis (37.5% vs. 2.1%, p<0.001) at presentation. Activity and chronicity indices [median (range)] were higher in the TMA group - 11 (2-19) and 3(1-8) respectively, compared with 7 (0-15) and 1 (0-3) in Controls, p=0.004 and <0.001. TMA group showed inferior renal survival, higher incidence of chronic kidney disease, and lower median eGFR at last follow-up (5-year renal survival 70%, 66.6% CKD at last follow-up, median eGFR 50.1 ml/min with IQR 7-132 ml/min) compared with Controls (95%, 29.2%, and 85.0 ml/min with IQR 12-147 ml/min; p=0.023, 0.002 and 0.003 respectively). There was no difference in patient survival between the two groups (p=0.127). CONCLUSIONS: Renal biopsy showing TMA was associated with more severe renal impairment at presentation and worse long-term renal outcome in LN.-
dc.languageeng-
dc.publisherEuropean Renal Association & European Dialysis and Transplant Association.-
dc.relation.ispartof55th European Renal Association & European Dialysis and Transplant Association (ERA-EDTA) Congress, 2018-
dc.titleClinical Characteristics and outcomes of lupus nephritis patients with kidney biopsy showing thrombotic microangiopathy-
dc.typeConference_Paper-
dc.identifier.emailYap, YHD: desmondy@hku.hk-
dc.identifier.emailTang, CSO: csotang@hkucc.hku.hk-
dc.identifier.emailChan, DTM: dtmchan@hkucc.hku.hk-
dc.identifier.authorityYap, YHD=rp01607-
dc.identifier.authorityChan, DTM=rp00394-
dc.identifier.hkuros290841-

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