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Causes and predictors of mortality from lupus nephritis in Southern Hunan, China
Peng Liu1, Zhong Peng1,2, Yazhou Xiang1
1Department of Nephrology, The First Affiliated Hospital of University of South China, Hengyang, Hunan Province, China.
Insights
This study identified key mortality predictors in Lupus Nephritis (LN) patients in China. The platelet-to-neutrophil ratio (PNR) emerged as a significant, novel predictor of mortality in LN.
Area of Science:
- Nephrology
- Immunology
- Internal Medicine
Background:
- Lupus Nephritis (LN) is a severe renal complication of Systemic Lupus Erythematosus (SLE).
- Understanding mortality predictors is crucial for improving patient outcomes in LN.
- Previous studies have not fully elucidated mortality causes and predictors in specific Chinese populations.
Purpose of the Study:
- To investigate the causes of mortality in a cohort of patients with Lupus Nephritis in southern Hunan, China.
- To identify independent predictors of mortality in this LN patient cohort.
Main Methods:
- Analysis of 236 patients with biopsy-proven LN from 2010-2018.
- Collection of demographic, laboratory, SLEDAI scores, treatment, and comorbidity data.
- Application of Cox regression analysis to determine independent mortality predictors.
Main Results:
- Class IV LN was the predominant biopsy class (38.1%).
- High remission rates were observed: 72.9% complete and 18.6% partial remission after one year.
- Independent predictors of mortality included platelet-to-neutrophil ratio (PNR), onset age, and SLEDAI scores. Main causes of death were infection and cardiovascular diseases.
Conclusions:
- The platelet-to-neutrophil ratio (PNR) is identified as a potential novel predictor of mortality in Lupus Nephritis.
- This study provides crucial insights into the causes and prognostic factors of mortality in LN patients from southern Hunan, China.
Objectives:
The objective of the study was to explore the causes and predictors of mortality in a cohort of LN with LN in southern Hunan, China.
Methods:
We analyzed 236 patients with biopsy-proven LN during 2010-2018. Demographic data, laboratory data, SLEDAI scores, treatment strategies, and comorbidity were collected. Cox regression analysis was carried out to determine the independent predictors of mortality.
Results:
The patients had mean disease duration of 67.9 ± 28.2 months. Class IV LN was the predominant biopsy class within the cohort (38.1%). After 1 year therapy, the majority of patients achieved complete remission (72.9%) and 44 (18.6%) patients achieved partial remission. The 5- and 10-years survival rates for our cohort were 94.4 and 85.2%, respectively. There were 18 deaths (7.6%), of which the main causes were infection (50%) alone and cardiovascular diseases (27.8%). Independent predictors of mortality in our cohort were: platelet-to-neutrophil ratio (PNR) [hazard ratio (HR) 5.910; confidence interval (CI) 1.253-27.875], onset age (HR 1.090; CI 1.035-1.147), and SLEDAI scores (HR 1.258; CI 1.068-1.482).
Conclusion:
We firstly revealed that PNR might be a promising predictor of mortality and reported the causes and prognostic predictors of mortality in LN from southern Hunan, China.
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