Risk factors for infections in patients with lupus nephritis and construction of a prediction model
ObjectiveTo investigate the risk factors for infection in lupus nephritis （LN） after starting immunosuppressive therapy.MethodsA total of 374 patients who were diagnosed with LN and received immunosuppressive therapy at Guangdong Provincial People's Hospital （Guangdong Academy of Medical Scienc...
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Editorial Department of Journal of Clinical Nephrology
2025-04-01
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| Series: | Linchuang shenzangbing zazhi |
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| Online Access: | http://www.lcszb.com/article/doi/10.3969/j.issn.1671-2390.2025.04.002 |
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| author | Liu Ding-lin Zhang Wen-hao Hu Hao-fei Li Ai-ting Chen Zhi-jin Zheng Cai-yan Qin Le-le Zhang Li Li Rui-zhao Ye Zhi-ming |
| author_facet | Liu Ding-lin Zhang Wen-hao Hu Hao-fei Li Ai-ting Chen Zhi-jin Zheng Cai-yan Qin Le-le Zhang Li Li Rui-zhao Ye Zhi-ming |
| author_sort | Liu Ding-lin |
| collection | DOAJ |
| description | ObjectiveTo investigate the risk factors for infection in lupus nephritis （LN） after starting immunosuppressive therapy.MethodsA total of 374 patients who were diagnosed with LN and received immunosuppressive therapy at Guangdong Provincial People's Hospital （Guangdong Academy of Medical Sciences），Southern Medical University from January 1， 2000 to December 31， 2020 were retrospectively collected. The basic conditions of the patients， renal pathologic indexes， baseline and changes in biochemical and immunologic indexes， and the occurrence of infections during follow-up were collected. Cox proportional risk regression model was used to analyze the factors affecting secondary infections.ResultsThe mean age of the included patients was （30 ± 12）years， and 85.3% of them were female. The mean follow-up period was 2 years. During the follow-up， 219 （58.6%） LN patients developed infections. Multifactorial Cox proportional risk regression model analysis showed that baseline IgM （HR=1.288，95% CI： 1.074-1.544， P=0.006） and free light chain λ levels （HR=1.783，95% CI： 1.000-3.177， P=0.050） were the risk factors for secondary infections in LN patients， whereas the reduction of double-stranded DNA （dsDNA） at 3 months of treatment （HR=0.728， 95% CI： 0.563-0.924， P=0.016） and hemoglobin elevation （HR=0.790，95% CI： 0.652-0.958， P=0.017） were protective factors for infection. After standardizing the variables and excluding patients with infections within 3 months， a multivariate analysis was performed， and a nomogram was constructed. The receiver operating characteristic （ROC） curve was plotted， and the area under the curve （AUC） of the nomogram was 0.825.ConclusionPatients with LN have a higher incidence of infections during the treatment period. High baseline levels of IgM and serum light chain λ are associated with an increased risk of infection after immunosuppressive therapy in LN patients， whereas a decrease in dsDNA antibodies and an increase in hemoglobin are associated with a decreased risk of infection in patients with LN within 3 months of treatment. The nomogram constructed in this study has a good predictive ability for the occurrence of risk factors for infection in LN patients. |
| format | Article |
| id | doaj-art-c24527d008d147b5945d45aecb919c98 |
| institution | OA Journals |
| issn | 1671-2390 |
| language | zho |
| publishDate | 2025-04-01 |
| publisher | Editorial Department of Journal of Clinical Nephrology |
| record_format | Article |
| series | Linchuang shenzangbing zazhi |
| spelling | doaj-art-c24527d008d147b5945d45aecb919c982025-08-20T02:24:30ZzhoEditorial Department of Journal of Clinical NephrologyLinchuang shenzangbing zazhi1671-23902025-04-0125427428110.3969/j.issn.1671-2390.2025.04.0021671-2390（2025）04-0274-08Risk factors for infections in patients with lupus nephritis and construction of a prediction modelLiu Ding-lin0Zhang Wen-hao1Hu Hao-fei2Li Ai-ting3Chen Zhi-jin4Zheng Cai-yan5Qin Le-le6Zhang Li7Li Rui-zhao8Ye Zhi-ming9South China University of Technology School of Medicine，Guangzhou 510006，ChinaDepartment of Nephrology，Guangdong Provincial People's Hospital （Guangdong Academy of Medical Sciences），Southern Medical University，Guangzhou 510080，ChinaDepartment of Nephrology，Shenzhen Second People's Hospital，Shenzhen 518035，ChinaDepartment of Nephrology，Guangdong Provincial People's Hospital （Guangdong Academy of Medical Sciences），Southern Medical University，Guangzhou 510080，ChinaDepartment of Nephrology，Guangdong Provincial People's Hospital （Guangdong Academy of Medical Sciences），Southern Medical University，Guangzhou 510080，ChinaDepartment of Nephrology，Guangdong Provincial People's Hospital （Guangdong Academy of Medical Sciences），Southern Medical University，Guangzhou 510080，ChinaDepartment of Nephrology，Guangdong Provincial People's Hospital （Guangdong Academy of Medical Sciences），Southern Medical University，Guangzhou 510080，ChinaDepartment of Nephrology，Guangdong Provincial People's Hospital （Guangdong Academy of Medical Sciences），Southern Medical University，Guangzhou 510080，ChinaDepartment of Nephrology，Guangdong Provincial People's Hospital （Guangdong Academy of Medical Sciences），Southern Medical University，Guangzhou 510080，ChinaSouth China University of Technology School of Medicine，Guangzhou 510006，ChinaObjectiveTo investigate the risk factors for infection in lupus nephritis （LN） after starting immunosuppressive therapy.MethodsA total of 374 patients who were diagnosed with LN and received immunosuppressive therapy at Guangdong Provincial People's Hospital （Guangdong Academy of Medical Sciences），Southern Medical University from January 1， 2000 to December 31， 2020 were retrospectively collected. The basic conditions of the patients， renal pathologic indexes， baseline and changes in biochemical and immunologic indexes， and the occurrence of infections during follow-up were collected. Cox proportional risk regression model was used to analyze the factors affecting secondary infections.ResultsThe mean age of the included patients was （30 ± 12）years， and 85.3% of them were female. The mean follow-up period was 2 years. During the follow-up， 219 （58.6%） LN patients developed infections. Multifactorial Cox proportional risk regression model analysis showed that baseline IgM （HR=1.288，95% CI： 1.074-1.544， P=0.006） and free light chain λ levels （HR=1.783，95% CI： 1.000-3.177， P=0.050） were the risk factors for secondary infections in LN patients， whereas the reduction of double-stranded DNA （dsDNA） at 3 months of treatment （HR=0.728， 95% CI： 0.563-0.924， P=0.016） and hemoglobin elevation （HR=0.790，95% CI： 0.652-0.958， P=0.017） were protective factors for infection. After standardizing the variables and excluding patients with infections within 3 months， a multivariate analysis was performed， and a nomogram was constructed. The receiver operating characteristic （ROC） curve was plotted， and the area under the curve （AUC） of the nomogram was 0.825.ConclusionPatients with LN have a higher incidence of infections during the treatment period. High baseline levels of IgM and serum light chain λ are associated with an increased risk of infection after immunosuppressive therapy in LN patients， whereas a decrease in dsDNA antibodies and an increase in hemoglobin are associated with a decreased risk of infection in patients with LN within 3 months of treatment. The nomogram constructed in this study has a good predictive ability for the occurrence of risk factors for infection in LN patients.http://www.lcszb.com/article/doi/10.3969/j.issn.1671-2390.2025.04.002lupus nephritissystemic lupus erythematosusinfection |
| spellingShingle | Liu Ding-lin Zhang Wen-hao Hu Hao-fei Li Ai-ting Chen Zhi-jin Zheng Cai-yan Qin Le-le Zhang Li Li Rui-zhao Ye Zhi-ming Risk factors for infections in patients with lupus nephritis and construction of a prediction model Linchuang shenzangbing zazhi lupus nephritis systemic lupus erythematosus infection |
| title | Risk factors for infections in patients with lupus nephritis and construction of a prediction model |
| title_full | Risk factors for infections in patients with lupus nephritis and construction of a prediction model |
| title_fullStr | Risk factors for infections in patients with lupus nephritis and construction of a prediction model |
| title_full_unstemmed | Risk factors for infections in patients with lupus nephritis and construction of a prediction model |
| title_short | Risk factors for infections in patients with lupus nephritis and construction of a prediction model |
| title_sort | risk factors for infections in patients with lupus nephritis and construction of a prediction model |
| topic | lupus nephritis systemic lupus erythematosus infection |
| url | http://www.lcszb.com/article/doi/10.3969/j.issn.1671-2390.2025.04.002 |
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