Back to Search Start Over

Role of tubulointerstitial lesions in predicting renal outcome among pediatric onset lupus nephritis - A retrospective cohort study.

Authors :
Wu CY
Chien HP
Yang HY
Yao TC
Tseng MH
Yu MC
Yeh KW
Huang JL
Source :
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi [J Microbiol Immunol Infect] 2020 Feb; Vol. 53 (1), pp. 33-41. Date of Electronic Publication: 2017 Dec 15.
Publication Year :
2020

Abstract

Background: Raising evidence suggested a prognostic utility of tubulointerstitial lesions in lupus nephritis (LN). The exact prevalence of tubulointerstitial abnormalities and its predictive value among pediatric onset systemic lupus erythematous (pSLE) cases, however, remained unknown.<br />Methods: Sixty-seven pSLE subjects diagnosed with LN with initial renal samples available were enrolled and followed for an average of 6.49 ± 3.06 years. Renal histology was evaluated according to the International Society of Nephrology/Renal Pathology Society classification, National Institute of Health classification and tubulointerstitial activity index (TIAI).<br />Results: Tubulointerstitial injuries were observed in 38.81% of all LN cases, including 13.33% with non-proliferative lupus nephritis (nPLN) and 46.15% of with proliferative lupus nephritis (PLN). Tubulointerstitial injuries occurred solitarily in cases with nPLN(13.33%), but always associated glomerular changes and significantly impacted renal survival (p = 0.032) among those with PLN. TIAI associated glomerular abnormalities (p = 0.031) but did not correlate renal performance or subsequent outcome (p = 0.445). Among the chronicity index, it was the chronic tubulointerstitial lesions that provided prognostic information (p = 0.012). None of the individual tubulointerstitial factors, however, reached statistical significance in end-stage renal disease prediction. Finally, considering tubulointerstitial injuries in PLN further discriminated subsequent renal outcome (p = 0.006).<br />Conclusion: Tubulointerstitial abnormalities were found in nearly one-third of all pediatric LN cases. With its importance in early identifying those at risk of renal failure, histologic classification considering tubulointerstitial lesions may potentially assist outcome prediction.<br /> (Copyright © 2017. Published by Elsevier B.V.)

Details

Language :
English
ISSN :
1995-9133
Volume :
53
Issue :
1
Database :
MEDLINE
Journal :
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi
Publication Type :
Academic Journal
Accession number :
29289551
Full Text :
https://doi.org/10.1016/j.jmii.2017.11.003