狼性炎与低水平蛋白尿的长期结果:一个多中心的回顾性研究
Takeshi Zoshima1, Satoshi Hara1, Kazuyuki Suzuki1
1Department of Rheumatology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
Rheumatology (Oxford, England)
|November 24, 2023
概括
患有狼性炎 (LN) 和低水平蛋白尿症的患者经历了有利的长期脏和整体生存结果. 这些患者的早期脏活检对于及时诊断和改善预后至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 内部医学 内部医学
背景情况:
- 狼性炎 (LN) 和低水平蛋白尿症患者通常被认为具有有利的短期结局.
- 然而,这组患者的长期结局和整体存活率需要进一步澄清.
- 需要了解早期脏活检在低水平蛋白尿症患者中的重要性.
研究的目的:
- 调查活检证明的狼性炎 (LN) 和低水平蛋白尿症患者的长期结局和整体存活率.
- 评估早期活检在治疗这些患者中的作用和意义.
- 确定与末期病 (ESRD) 和LN患者死亡相关的风险因素.
主要方法:
- 分析了来自10家医院的144名日本患有活检证明的LN患者队列.
- 低水平蛋白尿症被定义为尿中的蛋白质:肌素比 (UPCR) ≤1 g/gCr.
- 结果包括末期病 (ESRD) 和死亡,平均观察期为72个月. 统计分析包括卡普兰-梅尔和多变量考克斯回归.
主要成果:
- 低水平蛋白尿症患者 (UPCR ≤1 g/gCr) 与高水平蛋白尿症患者 (UPCR >1 g/gCr) 相比,表现出更好的功能,较低的活性和慢性指数,以及类似的III/IV类频率.
- 在观察期间,ESRD (3.0%对13.0%) 和死亡 (3.0%对16.9%) 的发生率在低水平蛋白尿症组显着较低.
- 多变量分析确定高慢性指数和高血压是ESRD的风险因素,而年龄增加和高水平蛋白尿是死亡的风险因素.
结论:
- 患有狼性炎和低水平蛋白尿症的患者表现出良好的长期脏和整体存活率.
- 尽管蛋白尿很低,但这些患者往往呈现出大量活跃的病理病变.
- 建议在低水平蛋白尿的早期阶段进行早期脏活检,以便及时诊断,治疗和改善预后.
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