Glomerular necrotic lesions and long-term outcomes among patients with proliferative lupus nephritis
Although necrotic lesions are common in proliferative lupus nephritis (LN), little is known about the impact of these lesions on outcomes. This study was undertaken to investigate the impact of glomerular necrotic lesions on renal outcomes of doubling serum creatinine in patients with class III and...
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| Veröffentlicht in: | International journal of clinical and experimental pathology 2015-01, Vol.8 (5), p.5787-5792 |
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| container_title | International journal of clinical and experimental pathology |
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| creator | Alsuwaida, Abdulkareem Husain, Sufia Al Ghonaim, Mohammed Alobaili, Saad Alwakeel, Jamal Al Sehli, Riyadh Askar, Akram Tarakji, Ahmad Kfoury, Hala |
| description | Although necrotic lesions are common in proliferative lupus nephritis (LN), little is known about the impact of these lesions on outcomes. This study was undertaken to investigate the impact of glomerular necrotic lesions on renal outcomes of doubling serum creatinine in patients with class III and IV LN and necrotic lesions.
52 patients with ISN/RPS class III or IV LN were enrolled in this retrospective study, with mean follow-up of 7.4 years. All patients underwent a repeat biopsy at 12-18 months after a baseline biopsy.
The prevalence of necrotizing lesions was observed in 24% of those with class III versus 70.4% with class IV (P=0.001). The rate of no remission was 44% and 22.2% in those with and without necrosis (P=0.007), respectively. The doubling of serum creatinine was observed in 32% of those with necrosis and in 14.8% with no necrosis (P=0.01). The chronicity index in the repeat biopsy was significantly worse among those with necrosis.
Glomerular necrosis identifies lupus nephritis patients at the greatest risk for progression to renal failure. Proactive intervention and possibly more aggressive induction therapies in patients with necrotizing lesions may protect the kidneys from developing chronic renal impairment. |
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52 patients with ISN/RPS class III or IV LN were enrolled in this retrospective study, with mean follow-up of 7.4 years. All patients underwent a repeat biopsy at 12-18 months after a baseline biopsy.
The prevalence of necrotizing lesions was observed in 24% of those with class III versus 70.4% with class IV (P=0.001). The rate of no remission was 44% and 22.2% in those with and without necrosis (P=0.007), respectively. The doubling of serum creatinine was observed in 32% of those with necrosis and in 14.8% with no necrosis (P=0.01). The chronicity index in the repeat biopsy was significantly worse among those with necrosis.
Glomerular necrosis identifies lupus nephritis patients at the greatest risk for progression to renal failure. Proactive intervention and possibly more aggressive induction therapies in patients with necrotizing lesions may protect the kidneys from developing chronic renal impairment.</description><identifier>EISSN: 1936-2625</identifier><identifier>PMID: 26191298</identifier><language>eng</language><publisher>United States: e-Century Publishing Corporation</publisher><subject>Adult ; Disease Progression ; Female ; Humans ; Kidney Glomerulus - pathology ; Lupus Nephritis - pathology ; Male ; Necrosis ; Original ; Retrospective Studies</subject><ispartof>International journal of clinical and experimental pathology, 2015-01, Vol.8 (5), p.5787-5792</ispartof><rights>IJCEP Copyright © 2015 2015</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4503169/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4503169/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26191298$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alsuwaida, Abdulkareem</creatorcontrib><creatorcontrib>Husain, Sufia</creatorcontrib><creatorcontrib>Al Ghonaim, Mohammed</creatorcontrib><creatorcontrib>Alobaili, Saad</creatorcontrib><creatorcontrib>Alwakeel, Jamal</creatorcontrib><creatorcontrib>Al Sehli, Riyadh</creatorcontrib><creatorcontrib>Askar, Akram</creatorcontrib><creatorcontrib>Tarakji, Ahmad</creatorcontrib><creatorcontrib>Kfoury, Hala</creatorcontrib><title>Glomerular necrotic lesions and long-term outcomes among patients with proliferative lupus nephritis</title><title>International journal of clinical and experimental pathology</title><addtitle>Int J Clin Exp Pathol</addtitle><description>Although necrotic lesions are common in proliferative lupus nephritis (LN), little is known about the impact of these lesions on outcomes. This study was undertaken to investigate the impact of glomerular necrotic lesions on renal outcomes of doubling serum creatinine in patients with class III and IV LN and necrotic lesions.
52 patients with ISN/RPS class III or IV LN were enrolled in this retrospective study, with mean follow-up of 7.4 years. All patients underwent a repeat biopsy at 12-18 months after a baseline biopsy.
The prevalence of necrotizing lesions was observed in 24% of those with class III versus 70.4% with class IV (P=0.001). The rate of no remission was 44% and 22.2% in those with and without necrosis (P=0.007), respectively. The doubling of serum creatinine was observed in 32% of those with necrosis and in 14.8% with no necrosis (P=0.01). The chronicity index in the repeat biopsy was significantly worse among those with necrosis.
Glomerular necrosis identifies lupus nephritis patients at the greatest risk for progression to renal failure. Proactive intervention and possibly more aggressive induction therapies in patients with necrotizing lesions may protect the kidneys from developing chronic renal impairment.</description><subject>Adult</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Humans</subject><subject>Kidney Glomerulus - pathology</subject><subject>Lupus Nephritis - pathology</subject><subject>Male</subject><subject>Necrosis</subject><subject>Original</subject><subject>Retrospective Studies</subject><issn>1936-2625</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkE1LxDAQhosg7rr6FyRHL4V8NW0ugiy6CoIXPZdsOt2NpEnNx4r_3oCr6GngmZfnHeakWhLJRE0FbRbVeYxvGAtCOT6rFlQQSajsltWwsX6CkK0KyIEOPhmNLETjXUTKDch6t6sThAn5nHTJFjwVhmaVDLgU0YdJezQHb80IocADIJvnHItv3geTTLyoTkdlI1we56p6vb97WT_UT8-bx_XtUz1TIVItulZzQhllXUu3lLRYM6VEJ6kUWHRMYE3VgKEFyTkQjkfCYav4wEc5tFSwVXXz7Z3zdoJBl_OCsv0czKTCZ--V6f9vnNn3O3_oeYMZEbIIro-C4N8zxNRPJmqwVjnwOfYl07aNaBgp0au_Xb8lP69lX9ETdwc</recordid><startdate>20150101</startdate><enddate>20150101</enddate><creator>Alsuwaida, Abdulkareem</creator><creator>Husain, Sufia</creator><creator>Al Ghonaim, Mohammed</creator><creator>Alobaili, Saad</creator><creator>Alwakeel, Jamal</creator><creator>Al Sehli, Riyadh</creator><creator>Askar, Akram</creator><creator>Tarakji, Ahmad</creator><creator>Kfoury, Hala</creator><general>e-Century Publishing Corporation</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150101</creationdate><title>Glomerular necrotic lesions and long-term outcomes among patients with proliferative lupus nephritis</title><author>Alsuwaida, Abdulkareem ; Husain, Sufia ; Al Ghonaim, Mohammed ; Alobaili, Saad ; Alwakeel, Jamal ; Al Sehli, Riyadh ; Askar, Akram ; Tarakji, Ahmad ; Kfoury, Hala</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p266t-687c412323872b2170c3aa689296068360c2ad0e7e944e140f14eba4d4f9d7263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Humans</topic><topic>Kidney Glomerulus - pathology</topic><topic>Lupus Nephritis - pathology</topic><topic>Male</topic><topic>Necrosis</topic><topic>Original</topic><topic>Retrospective Studies</topic><toplevel>online_resources</toplevel><creatorcontrib>Alsuwaida, Abdulkareem</creatorcontrib><creatorcontrib>Husain, Sufia</creatorcontrib><creatorcontrib>Al Ghonaim, Mohammed</creatorcontrib><creatorcontrib>Alobaili, Saad</creatorcontrib><creatorcontrib>Alwakeel, Jamal</creatorcontrib><creatorcontrib>Al Sehli, Riyadh</creatorcontrib><creatorcontrib>Askar, Akram</creatorcontrib><creatorcontrib>Tarakji, Ahmad</creatorcontrib><creatorcontrib>Kfoury, Hala</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of clinical and experimental pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alsuwaida, Abdulkareem</au><au>Husain, Sufia</au><au>Al Ghonaim, Mohammed</au><au>Alobaili, Saad</au><au>Alwakeel, Jamal</au><au>Al Sehli, Riyadh</au><au>Askar, Akram</au><au>Tarakji, Ahmad</au><au>Kfoury, Hala</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Glomerular necrotic lesions and long-term outcomes among patients with proliferative lupus nephritis</atitle><jtitle>International journal of clinical and experimental pathology</jtitle><addtitle>Int J Clin Exp Pathol</addtitle><date>2015-01-01</date><risdate>2015</risdate><volume>8</volume><issue>5</issue><spage>5787</spage><epage>5792</epage><pages>5787-5792</pages><eissn>1936-2625</eissn><abstract>Although necrotic lesions are common in proliferative lupus nephritis (LN), little is known about the impact of these lesions on outcomes. This study was undertaken to investigate the impact of glomerular necrotic lesions on renal outcomes of doubling serum creatinine in patients with class III and IV LN and necrotic lesions.
52 patients with ISN/RPS class III or IV LN were enrolled in this retrospective study, with mean follow-up of 7.4 years. All patients underwent a repeat biopsy at 12-18 months after a baseline biopsy.
The prevalence of necrotizing lesions was observed in 24% of those with class III versus 70.4% with class IV (P=0.001). The rate of no remission was 44% and 22.2% in those with and without necrosis (P=0.007), respectively. The doubling of serum creatinine was observed in 32% of those with necrosis and in 14.8% with no necrosis (P=0.01). The chronicity index in the repeat biopsy was significantly worse among those with necrosis.
Glomerular necrosis identifies lupus nephritis patients at the greatest risk for progression to renal failure. Proactive intervention and possibly more aggressive induction therapies in patients with necrotizing lesions may protect the kidneys from developing chronic renal impairment.</abstract><cop>United States</cop><pub>e-Century Publishing Corporation</pub><pmid>26191298</pmid><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Adult Disease Progression Female Humans Kidney Glomerulus - pathology Lupus Nephritis - pathology Male Necrosis Original Retrospective Studies |
| title | Glomerular necrotic lesions and long-term outcomes among patients with proliferative lupus nephritis |
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