Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis
Objective To evaluate the performance of the European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) SLE classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis (LN) and their renal prognosis.Methods Patients with newly diagnosed SLE attending an...
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BMJ Publishing Group
2021-04-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/8/1/e000458.full |
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| author | Fei Han Jianghua Chen Lan Lan Yanhong Ma Huijing Wang Yunjie Gao Fanghao Cai Xiaohan Huang Pingping Ren Yaomin Wang |
| author_facet | Fei Han Jianghua Chen Lan Lan Yanhong Ma Huijing Wang Yunjie Gao Fanghao Cai Xiaohan Huang Pingping Ren Yaomin Wang |
| author_sort | Fei Han |
| collection | DOAJ |
| description | Objective To evaluate the performance of the European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) SLE classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis (LN) and their renal prognosis.Methods Patients with newly diagnosed SLE attending and followed up for >12 months were included. A retrospective review of all patients with renal biopsy fulfilling a consensus expert opinion during 2014 and 2018. Clinical, serological and pathological data were collected and each patient was assigned a high/low criteria scores (HS/LS) group. Survival curves for flare adjusted for multiplicity on renal flares, was applied to the two groups.Results Applying EULAR/ACR criteria in our cohort of 126 patients, 6 (4.76%) did not meet the criterion, resulting in a sensitivity of 95.24%. The EULAR/ACR criteria scores was positively correlated with SLE disease activity index scores. Additionally, we noticed that a significant difference in clinical and immunological manifestations between HS and LS group. We observed a higher proportions of class Ⅲ or Ⅳ LN and lower proportions of class Ⅱ or V LN (p=0.034) and pathological higher activity index in HS group (p=0.007). Compared with LS groups, patients involved more severe renal damage and achieved higher rate of complete remission in the HS group. The Kaplan-Meier exploratory analyses, adjusted for LN classification, estimated glomerular filtration rate, activity index and chronicity index and induction and maintenance treatments, showed that patients in the HS group had a tendency of higher renal flare risk than that in the LS group (HR=0.21, p=0.04).Conclusions The EULAR/ACR criteria performed high sensitivity in identifying SLE in this cohort of biopsy-confirmed LN. Patients with LN with high criteria scores had more extrarenal manifestations, and worse renal prognosis in the short and long terms. |
| format | Article |
| id | doaj-art-42b10cb879d44c8794274080e3be1d5c |
| institution | Kabale University |
| issn | 2053-8790 |
| language | English |
| publishDate | 2021-04-01 |
| publisher | BMJ Publishing Group |
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| series | Lupus Science and Medicine |
| spelling | doaj-art-42b10cb879d44c8794274080e3be1d5c2024-12-16T18:40:10ZengBMJ Publishing GroupLupus Science and Medicine2053-87902021-04-018110.1136/lupus-2020-000458Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritisFei Han0Jianghua Chen1Lan Lan2Yanhong Ma3Huijing Wang4Yunjie Gao5Fanghao Cai6Xiaohan Huang7Pingping Ren8Yaomin Wang9Kidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaKidney Disease Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaDepartment of Rehabilitation Medicine, Shanghai Sixth People`s Hospital, Shanghai, ChinaZhejiang Clinical Research Center of Kidney and Urinary System Disease, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaObjective To evaluate the performance of the European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) SLE classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis (LN) and their renal prognosis.Methods Patients with newly diagnosed SLE attending and followed up for >12 months were included. A retrospective review of all patients with renal biopsy fulfilling a consensus expert opinion during 2014 and 2018. Clinical, serological and pathological data were collected and each patient was assigned a high/low criteria scores (HS/LS) group. Survival curves for flare adjusted for multiplicity on renal flares, was applied to the two groups.Results Applying EULAR/ACR criteria in our cohort of 126 patients, 6 (4.76%) did not meet the criterion, resulting in a sensitivity of 95.24%. The EULAR/ACR criteria scores was positively correlated with SLE disease activity index scores. Additionally, we noticed that a significant difference in clinical and immunological manifestations between HS and LS group. We observed a higher proportions of class Ⅲ or Ⅳ LN and lower proportions of class Ⅱ or V LN (p=0.034) and pathological higher activity index in HS group (p=0.007). Compared with LS groups, patients involved more severe renal damage and achieved higher rate of complete remission in the HS group. The Kaplan-Meier exploratory analyses, adjusted for LN classification, estimated glomerular filtration rate, activity index and chronicity index and induction and maintenance treatments, showed that patients in the HS group had a tendency of higher renal flare risk than that in the LS group (HR=0.21, p=0.04).Conclusions The EULAR/ACR criteria performed high sensitivity in identifying SLE in this cohort of biopsy-confirmed LN. Patients with LN with high criteria scores had more extrarenal manifestations, and worse renal prognosis in the short and long terms.https://lupus.bmj.com/content/8/1/e000458.full |
| spellingShingle | Fei Han Jianghua Chen Lan Lan Yanhong Ma Huijing Wang Yunjie Gao Fanghao Cai Xiaohan Huang Pingping Ren Yaomin Wang Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis Lupus Science and Medicine |
| title | Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis |
| title_full | Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis |
| title_fullStr | Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis |
| title_full_unstemmed | Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis |
| title_short | Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis |
| title_sort | performance of the 2019 eular acr systemic lupus erythematosus classification criteria in a cohort of patients with biopsy confirmed lupus nephritis |
| url | https://lupus.bmj.com/content/8/1/e000458.full |
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