Clinicopathological characteristics and outcomes of lupus nephritis patients with scanty immune depositions in kidney biopsies
Background The clinicopathological features, outcomes, and pathogenesis of lupus nephritis with scanty immune deposits in the kidney biopsy remain unclear. Methods Four hundred ninety-eight biopsy-proven lupus nephritis patients were included, and clinical and pathological data were collected. The p...
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| Veröffentlicht in: | Journal of nephrology 2023-11, Vol.36 (8), p.2345-2354 |
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| creator | Fan, Yuting Kang, Di Chen, Zhiqing Lu, Yuewen Huang, Xiamin Xia, Xi Chen, Wei |
| description | Background
The clinicopathological features, outcomes, and pathogenesis of lupus nephritis with scanty immune deposits in the kidney biopsy remain unclear.
Methods
Four hundred ninety-eight biopsy-proven lupus nephritis patients were included, and clinical and pathological data were collected. The primary endpoint was mortality, while the secondary endpoint was doubling baseline serum creatinine or end-stage renal disease. Associations between scanty immune deposits lupus nephritis and adverse outcomes were analyzed by Cox regression models.
Results
Among 498 lupus nephritis patients, 81 were diagnosed with scanty immune deposits. Patients with scanty immune deposits had significantly higher serum albumin and serum complement C4 than those with immune complex deposits. The proportion of anti-neutrophil cytoplasmic antibodies was similar between the two groups. In addition, patients with scanty immune deposits showed less proliferative features at kidney biopsy and lower activity index score, accompanied by milder mesangial cell and matrix hyperplasia, endothelial cell hyperplasia, nuclear fragmentation, and glomerular leukocyte infiltration. Patients in this group also had a milder degree of foot process fusion. Overall, renal survival and patient survival showed no significant difference between the two groups. 24-h proteinuria and chronicity index were significant risk factors for renal survival, and 24-h proteinuria and positive anti-neutrophil cytoplasmic antibodies were risk factors for patient survival in scanty immune deposits lupus nephritis patients.
Conclusions
Compared with other lupus nephritis patients, scanty immune deposits lupus nephritis patients had significantly lower activity features on kidney biopsy, but have similar outcomes. Positive anti-neutrophil cytoplasmic antibodies may be a risk factor for patient survival in scanty immune deposits lupus nephritis patients.
Graphical abstract |
| doi_str_mv | 10.1007/s40620-023-01622-y |
| format | Article |
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The clinicopathological features, outcomes, and pathogenesis of lupus nephritis with scanty immune deposits in the kidney biopsy remain unclear.
Methods
Four hundred ninety-eight biopsy-proven lupus nephritis patients were included, and clinical and pathological data were collected. The primary endpoint was mortality, while the secondary endpoint was doubling baseline serum creatinine or end-stage renal disease. Associations between scanty immune deposits lupus nephritis and adverse outcomes were analyzed by Cox regression models.
Results
Among 498 lupus nephritis patients, 81 were diagnosed with scanty immune deposits. Patients with scanty immune deposits had significantly higher serum albumin and serum complement C4 than those with immune complex deposits. The proportion of anti-neutrophil cytoplasmic antibodies was similar between the two groups. In addition, patients with scanty immune deposits showed less proliferative features at kidney biopsy and lower activity index score, accompanied by milder mesangial cell and matrix hyperplasia, endothelial cell hyperplasia, nuclear fragmentation, and glomerular leukocyte infiltration. Patients in this group also had a milder degree of foot process fusion. Overall, renal survival and patient survival showed no significant difference between the two groups. 24-h proteinuria and chronicity index were significant risk factors for renal survival, and 24-h proteinuria and positive anti-neutrophil cytoplasmic antibodies were risk factors for patient survival in scanty immune deposits lupus nephritis patients.
Conclusions
Compared with other lupus nephritis patients, scanty immune deposits lupus nephritis patients had significantly lower activity features on kidney biopsy, but have similar outcomes. Positive anti-neutrophil cytoplasmic antibodies may be a risk factor for patient survival in scanty immune deposits lupus nephritis patients.
Graphical abstract</description><identifier>ISSN: 1724-6059</identifier><identifier>EISSN: 1724-6059</identifier><identifier>DOI: 10.1007/s40620-023-01622-y</identifier><identifier>PMID: 37341964</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Humans ; Hyperplasia - complications ; Hyperplasia - pathology ; Kidney - pathology ; Lupus Nephritis ; Medicine ; Medicine & Public Health ; Nephrology ; original Article ; Proteinuria - pathology ; Urology</subject><ispartof>Journal of nephrology, 2023-11, Vol.36 (8), p.2345-2354</ispartof><rights>The Author(s) under exclusive licence to Italian Society of Nephrology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s) under exclusive licence to Italian Society of Nephrology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-50a4dbc7a94538f8250aa45bec4fce6d01490e4089313c7732bf057d71ff4f973</citedby><cites>FETCH-LOGICAL-c347t-50a4dbc7a94538f8250aa45bec4fce6d01490e4089313c7732bf057d71ff4f973</cites><orcidid>0000-0003-3146-5567 ; 0000-0001-7194-8040</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40620-023-01622-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40620-023-01622-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37341964$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fan, Yuting</creatorcontrib><creatorcontrib>Kang, Di</creatorcontrib><creatorcontrib>Chen, Zhiqing</creatorcontrib><creatorcontrib>Lu, Yuewen</creatorcontrib><creatorcontrib>Huang, Xiamin</creatorcontrib><creatorcontrib>Xia, Xi</creatorcontrib><creatorcontrib>Chen, Wei</creatorcontrib><title>Clinicopathological characteristics and outcomes of lupus nephritis patients with scanty immune depositions in kidney biopsies</title><title>Journal of nephrology</title><addtitle>J Nephrol</addtitle><addtitle>J Nephrol</addtitle><description>Background
The clinicopathological features, outcomes, and pathogenesis of lupus nephritis with scanty immune deposits in the kidney biopsy remain unclear.
Methods
Four hundred ninety-eight biopsy-proven lupus nephritis patients were included, and clinical and pathological data were collected. The primary endpoint was mortality, while the secondary endpoint was doubling baseline serum creatinine or end-stage renal disease. Associations between scanty immune deposits lupus nephritis and adverse outcomes were analyzed by Cox regression models.
Results
Among 498 lupus nephritis patients, 81 were diagnosed with scanty immune deposits. Patients with scanty immune deposits had significantly higher serum albumin and serum complement C4 than those with immune complex deposits. The proportion of anti-neutrophil cytoplasmic antibodies was similar between the two groups. In addition, patients with scanty immune deposits showed less proliferative features at kidney biopsy and lower activity index score, accompanied by milder mesangial cell and matrix hyperplasia, endothelial cell hyperplasia, nuclear fragmentation, and glomerular leukocyte infiltration. Patients in this group also had a milder degree of foot process fusion. Overall, renal survival and patient survival showed no significant difference between the two groups. 24-h proteinuria and chronicity index were significant risk factors for renal survival, and 24-h proteinuria and positive anti-neutrophil cytoplasmic antibodies were risk factors for patient survival in scanty immune deposits lupus nephritis patients.
Conclusions
Compared with other lupus nephritis patients, scanty immune deposits lupus nephritis patients had significantly lower activity features on kidney biopsy, but have similar outcomes. Positive anti-neutrophil cytoplasmic antibodies may be a risk factor for patient survival in scanty immune deposits lupus nephritis patients.
Graphical abstract</description><subject>Antibodies, Antineutrophil Cytoplasmic</subject><subject>Biopsy</subject><subject>Humans</subject><subject>Hyperplasia - complications</subject><subject>Hyperplasia - pathology</subject><subject>Kidney - pathology</subject><subject>Lupus Nephritis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrology</subject><subject>original Article</subject><subject>Proteinuria - pathology</subject><subject>Urology</subject><issn>1724-6059</issn><issn>1724-6059</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtu1TAQhi1ERUvLC7BAXrIJ-JY4WaIjblIlNu3acpxxj0tiB48jlBWvwrPwZBhOQaxYjTX-_l-aj5DnnL3ijOnXqFgnWMOEbBjvhGj2R-SCa6GajrXD43_e5-Qp4j1jom2FekLOpZaKD526IN8Oc4jBpdWWY5rTXXB2pu5os3UFcsASHFIbJ5q24tICSJOn87ZuSCOsxxxKQFrDAWJB-jWUI0VnY9lpWJYtAp1gTVipFJGGSD-HKcL-4_sY0ooB8IqceTsjPHuYl-T23dubw4fm-tP7j4c3142TSpemZVZNo9N2UK3sfS_qwqp2BKe8g25iXA0MFOsHyaXTWorRs1ZPmnuv_KDlJXl56l1z-rIBFrMEdDDPNkLa0Ihe9LLjvewrKk6oywkxgzdrDovNu-HM_BJvTuJNFW9-izd7Db146N_GBaa_kT-mKyBPANaveAfZ3Kctx3rz_2p_ApeVk2M</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Fan, Yuting</creator><creator>Kang, Di</creator><creator>Chen, Zhiqing</creator><creator>Lu, Yuewen</creator><creator>Huang, Xiamin</creator><creator>Xia, Xi</creator><creator>Chen, Wei</creator><general>Springer International Publishing</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3146-5567</orcidid><orcidid>https://orcid.org/0000-0001-7194-8040</orcidid></search><sort><creationdate>20231101</creationdate><title>Clinicopathological characteristics and outcomes of lupus nephritis patients with scanty immune depositions in kidney biopsies</title><author>Fan, Yuting ; Kang, Di ; Chen, Zhiqing ; Lu, Yuewen ; Huang, Xiamin ; Xia, Xi ; Chen, Wei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-50a4dbc7a94538f8250aa45bec4fce6d01490e4089313c7732bf057d71ff4f973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Antibodies, Antineutrophil Cytoplasmic</topic><topic>Biopsy</topic><topic>Humans</topic><topic>Hyperplasia - complications</topic><topic>Hyperplasia - pathology</topic><topic>Kidney - pathology</topic><topic>Lupus Nephritis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrology</topic><topic>original Article</topic><topic>Proteinuria - pathology</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fan, Yuting</creatorcontrib><creatorcontrib>Kang, Di</creatorcontrib><creatorcontrib>Chen, Zhiqing</creatorcontrib><creatorcontrib>Lu, Yuewen</creatorcontrib><creatorcontrib>Huang, Xiamin</creatorcontrib><creatorcontrib>Xia, Xi</creatorcontrib><creatorcontrib>Chen, Wei</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fan, Yuting</au><au>Kang, Di</au><au>Chen, Zhiqing</au><au>Lu, Yuewen</au><au>Huang, Xiamin</au><au>Xia, Xi</au><au>Chen, Wei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinicopathological characteristics and outcomes of lupus nephritis patients with scanty immune depositions in kidney biopsies</atitle><jtitle>Journal of nephrology</jtitle><stitle>J Nephrol</stitle><addtitle>J Nephrol</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>36</volume><issue>8</issue><spage>2345</spage><epage>2354</epage><pages>2345-2354</pages><issn>1724-6059</issn><eissn>1724-6059</eissn><abstract>Background
The clinicopathological features, outcomes, and pathogenesis of lupus nephritis with scanty immune deposits in the kidney biopsy remain unclear.
Methods
Four hundred ninety-eight biopsy-proven lupus nephritis patients were included, and clinical and pathological data were collected. The primary endpoint was mortality, while the secondary endpoint was doubling baseline serum creatinine or end-stage renal disease. Associations between scanty immune deposits lupus nephritis and adverse outcomes were analyzed by Cox regression models.
Results
Among 498 lupus nephritis patients, 81 were diagnosed with scanty immune deposits. Patients with scanty immune deposits had significantly higher serum albumin and serum complement C4 than those with immune complex deposits. The proportion of anti-neutrophil cytoplasmic antibodies was similar between the two groups. In addition, patients with scanty immune deposits showed less proliferative features at kidney biopsy and lower activity index score, accompanied by milder mesangial cell and matrix hyperplasia, endothelial cell hyperplasia, nuclear fragmentation, and glomerular leukocyte infiltration. Patients in this group also had a milder degree of foot process fusion. Overall, renal survival and patient survival showed no significant difference between the two groups. 24-h proteinuria and chronicity index were significant risk factors for renal survival, and 24-h proteinuria and positive anti-neutrophil cytoplasmic antibodies were risk factors for patient survival in scanty immune deposits lupus nephritis patients.
Conclusions
Compared with other lupus nephritis patients, scanty immune deposits lupus nephritis patients had significantly lower activity features on kidney biopsy, but have similar outcomes. Positive anti-neutrophil cytoplasmic antibodies may be a risk factor for patient survival in scanty immune deposits lupus nephritis patients.
Graphical abstract</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>37341964</pmid><doi>10.1007/s40620-023-01622-y</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-3146-5567</orcidid><orcidid>https://orcid.org/0000-0001-7194-8040</orcidid></addata></record> |
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| subjects | Antibodies, Antineutrophil Cytoplasmic Biopsy Humans Hyperplasia - complications Hyperplasia - pathology Kidney - pathology Lupus Nephritis Medicine Medicine & Public Health Nephrology original Article Proteinuria - pathology Urology |
| title | Clinicopathological characteristics and outcomes of lupus nephritis patients with scanty immune depositions in kidney biopsies |
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