Risk factors for acute kidney injury and kidney relapse in patients with lupus podocytopathy

作者：Wen Xia, Jiayi Deng, Lulu Zhuang, Feng Xu, Ying Jin, Houan Zhou, Ti Zhang, Zhengzhao Liu, Zhengzhao Liu, Haitao Zhang, Caihong Zeng, Zhihong Liu, Zhihong Liu, Weixin Hu · 发表于：Clinical Kidney Journal · 年份：2024 · DOI：10.1093/ckj/sfae148 · 被引用次数：9 · 研究领域：Systemic Lupus Erythematosus Research、Renal Diseases and Glomerulopathies、Vasculitis and related conditions

Background: Patients with lupus podocytopathy show a high incidence of acute kidney injury (AKI) and relapse, but the risk factors and mechanisms were unclear. This study analysed the clinicopathological features and risk factors for AKI and relapse in lupus podocytopathy patients. Methods: The cohort of lupus podocytopathy was generated by screening the biopsies of patients with lupus nephritis (LN) from 2002 to 2022 and was divided into the mild glomerular lesion (MGL) and focal segmental glomerulosclerosis (FSGS) groups based on glomerular morphological characteristics. The acute (ATI) and chronic (CTI) tubulointerstitial lesions were semi-quantitatively scored. Logistic and Cox regressions were employed to identify the risk factors for AKI and relapse, respectively. Results: Among 6052 LN cases, 98 (1.6%) were diagnosed as lupus podocytopathy, with 71 in the MGL group and 27 in the FSGS group. All patients presented with nephrotic syndrome and 33 (34.7%) of them had AKI. Seventy-seven (78.6%) patients achieved complete renal response (CRR) within 12 weeks of induction treatment, in which there was no difference in the CRR rate between glucocorticoid monotherapy and combination therapy with glucocorticoids plus immunosuppressants. Compared with the MGL group, patients in the FSGS group had significantly higher incidences of hypertension and haematuria; in addition, they had higher Systemic Lupus Erythematosus Disease Activity Index 2000, ATI and CTI scores but a significan...