基线蛋白尿水平对狼性炎的长期结果的影响
Fadi Kharouf1, Qixuan Li1, Laura P Whittall Garcia1
1Division of Rheumatology, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, University of Toronto Lupus Clinic, Toronto, ON, Canada.
Rheumatology (Oxford, England)
|October 24, 2024
概括
狼性炎 (LN) 患者的高基线蛋白尿预示着更糟糕的长期结果. 即使是低水平的蛋白尿也可能与LN增殖和不良结果有关,强调需要仔细监测.
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:
- 蛋白尿是狼性炎 (LN) 活动和损伤的关键指标.
- 了解初始蛋白尿水平对患者长期结果的影响对于有效的疾病管理至关重要.
研究的目的:
- 调查不同基线蛋白尿水平如何影响狼性炎患者的长期结果.
- 确定与疾病进展和不良事件相关的特定蛋白尿值.
主要方法:
- 分析了249名首次活检证明的狼性炎患者的队列.
- 患者根据基线蛋白尿分为三组:低 (≤1克/天),中度 (>1至<3克/天) 和高 (≥3克/天).
- 评估的结果包括1年后蛋白尿完全恢复,末期脏病 (ESKD) 的复合,持续的eGFR下降或死亡,以及使用Cox比例危险模型分析的狼性炎爆发.
主要成果:
- 一年后蛋白尿完全恢复率在低水平蛋白尿组中最高,在高水平蛋白尿组中最低.
- 在平均8.4年的随访期间,不良综合结局发生在27.4% (低),26.7% (中等) 和48.5% (高) 的患者中 (P=0.003).
- 狼性炎发作在较高蛋白尿症组 (27.4%低,38.2%中度,61.9%高;P<0.001) 中明显更频繁,高水平蛋白尿与最差的预后相关.
结论:
- 低水平的蛋白尿,通常与多发性狼性炎有关,可以预测不利的长期结果.
- 患有高基线蛋白尿症 (≥3g/天) 的患者在功能和疾病爆发方面面临着明显更差的预后.
- 这些发现强调了基线蛋白尿水平作为狼性炎管理中的预后因素的重要性.
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