Clinicopathological characteristics and renal outcomes of childhood-onset lupus nephritis with acute kidney injury: A multicenter study

Objectives: Acute kidney injury (AKI) at onset of adult systemic lupus erythematosus (SLE) is a risk factor for end stage kidney disease (ESKD). However, data on childhood-onset lupus nephritis (LN) with AKI are scarce. Methods: We retrospectively reviewed the complete files of pediatric SLE patient...

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Published in:Modern rheumatology 2019-11, Vol.29 (6), p.970-976
Main Authors: Ishimori, Shingo, Kaito, Hiroshi, Shima, Yuko, Kamioka, Ichiro, Hamahira, Kiyoshi, Nozu, Kandai, Nakanishi, Koichi, Tanaka, Ryojiro, Yoshikawa, Norishige, Iijima, Kazumoto
Format: Article
Language:English
Subjects:
Acute kidney injury
Adolescent
Adult
Child
childhood-onset
Female
Humans
Kidney Failure, Chronic - epidemiology
Kidney Failure, Chronic - etiology
lupus nephritis
Lupus Nephritis - complications
Lupus Nephritis - pathology
Lupus Nephritis - therapy
Male
renal prognosis
Risk Factors
Survival Rate
systemic lupus erythematosus
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Summary:Objectives: Acute kidney injury (AKI) at onset of adult systemic lupus erythematosus (SLE) is a risk factor for end stage kidney disease (ESKD). However, data on childhood-onset lupus nephritis (LN) with AKI are scarce. Methods: We retrospectively reviewed the complete files of pediatric SLE patients from 1995 to 2010. All patients underwent kidney biopsy promptly after diagnosis. Results: Thirty-six patients (10 males and 26 females) were enrolled. Mean age at diagnosis and observation period were 11.6 ± 2.4 and 8.1 ± 4.4 years, respectively. Seven patients had AKI at onset of SLE. Compared with those without AKI, patients with AKI had significantly higher proportions of pathologically proliferative LN. Only one patient with AKI progressed to ESKD without complete recovery of renal function. Overall and renal survival rates were 100and 97.2%, respectively. There was no significant difference in estimated glomerular filtration rate at the final visit (85ml/min/1.73 m 2 in the AKI group vs. 103.2 ml/min/1.73 m 2 in the non-AKI group; p = .11). Conclusion: Our study demonstrated favorable renal outcomes in childhood-onset LN with AKI in the near to midterm period. Inducing complete remission may be important for preserving renal function.
ISSN:1439-7595
1439-7609
DOI:10.1080/14397595.2018.1532861