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Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
Published on: June 8, 2022
Effects of remnant cholesterol on adverse renal outcomes in lupus nephritis
Xiaolei Shi1,2, Xinxin Zhang1,2, Yuewen Lu1,2
1Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, 58th, Zhongshan Road II, Guangzhou, 510080, Guangdong, China.
Insights
Higher remnant cholesterol (RC) levels are linked to poor kidney outcomes in lupus nephritis (LN). This suggests RC can be a valuable, non-invasive prognostic tool for assessing LN progression and guiding patient management.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Immunology
Background:
- Remnant cholesterol (RC) is implicated in inflammation and kidney disease development.
- The specific role of RC in lupus nephritis (LN) pathogenesis and prognosis is not well-defined.
- Understanding RC's impact is crucial for managing LN patients and preventing renal complications.
Purpose of the Study:
- To investigate the association between remnant cholesterol (RC) levels and the risk of adverse renal outcomes in patients with lupus nephritis (LN).
- To determine if RC can serve as a prognostic biomarker for disease progression in LN.
- To stratify LN patients based on RC levels and evaluate renal outcome risks.
Main Methods:
- An observational study of 909 patients diagnosed with lupus nephritis (LN) between 2000 and 2018.
- Patients were categorized into lower and higher RC groups using an optimal cutoff value of 86.88 mg/dL.
- Survival analyses, including Kaplan-Meier curves and multivariate Cox regression, were employed to assess renal outcomes (serum creatinine doubling, end-stage renal disease).
Main Results:
- Over a median follow-up of 8.33 years, 14.74% of patients experienced adverse renal outcomes.
- Higher RC levels were significantly associated with an increased risk of poor renal outcomes in LN patients (P < 0.001).
- Multivariate analysis confirmed higher RC as an independent predictor of adverse renal outcomes (HR: 1.98, 95% CI: 1.16-3.39).
Conclusions:
- Elevated remnant cholesterol (RC) levels are significantly associated with poor renal outcomes in lupus nephritis (LN).
- RC demonstrates potential as a non-invasive prognostic biomarker for clinical assessment and risk stratification in LN patients.
- Targeting RC may offer a novel therapeutic strategy to improve renal outcomes in LN.
Background:
Remnant cholesterol (RC) causes inflammation and promotes kidney diseases development. However, its role in lupus nephritis (LN) remains unclear. The purpose of this study was to investigate the association between RC and LN.
Methods:
This observational study was conducted among patients enrolled between 2000 and 2018 in the High Quality Evidence of Guangzhou Lupus Nephritis Cohort. The study outcomes were defined as adverse renal outcomes, including serum creatinine doubled and end-stage renal disease. Patients were stratified into lower and higher RC groups based on the optimal cutoff RC value (86.88 mg/dL) for adverse renal outcomes. To explore the association between renal outcomes and RC, survival analyses, multivariate Cox regression analyses, and subgroup analyses were conducted.
Results:
Overall, 909 individuals were enrolled. Over a median follow-up of 8.33 (interquartile range, 3.08-12.83) years, 134(14.74%) of them reached renal endpoints. Kaplan-Meier survival analyses indicated that patients with higher RC levels were more susceptible to adverse renal outcomes in LN (P < 0.001). After adjusting for confounding factors, higher RC levels exhibited significant correlations with adverse renal outcomes in LN [hazard ratio (HR):1.98, 95% confidence interval (CI):1.16-3.39; P = 0.012]. Subgroup analyses revealed a strong relationship between the higher RC and adverse renal outcomes, particularly in patients aged < 40 years, with an estimated glomerular filtration rate < 60 ml/min/1.73m2 or proliferative pathological changes or nephrotic syndrome (P < 0.05).
Conclusions:
Higher RC levels were significantly associated with poor renal outcomes in LN, indicating that RC may become a non-invasive prognostic tool in clinical assessment of LN.
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