Risk factors influencing curative effect of class Ⅳ lupus nephritis

Objective To investigate the clinical risk factors for unresponsive common approaches on the treatment of class IV lupus nephritis(LN).Methods The class IV LN patients were confirmed by renal biopsy,treated with glucocorticoid and common immunosuppressive agents and followed up for more than6 months...

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Main Authors: ZHANG Yu-rong, QI Yuan-yuan, MA Xiao, MENG Rui-xia, YANG Yan, WANG Jing
Format: Article
Language:zho
Published: Editorial Department of Journal of Clinical Nephrology 2017-01-01
Series:Linchuang shenzangbing zazhi
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Online Access:http://www.lcszb.com/thesisDetails?columnId=57916920&Fpath=home&index=0
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author ZHANG Yu-rong
QI Yuan-yuan
MA Xiao
MENG Rui-xia
YANG Yan
WANG Jing
author_facet ZHANG Yu-rong
QI Yuan-yuan
MA Xiao
MENG Rui-xia
YANG Yan
WANG Jing
author_sort ZHANG Yu-rong
collection DOAJ
description Objective To investigate the clinical risk factors for unresponsive common approaches on the treatment of class IV lupus nephritis(LN).Methods The class IV LN patients were confirmed by renal biopsy,treated with glucocorticoid and common immunosuppressive agents and followed up for more than6 months.They were divided into two groups according to curative effect after treatment for 6months.The differences between the two groups were analyzed by means of demographic characteristics,clinical manifestations,laboratory tests,autoantibodies,pathologic indicators,treatment regimens and outcomes.The possible influencing risk factors on the classⅣ LN were analyzed by Kaplan-Meier,and the independent risk factors were analyzed by multivariate COX regression modeling.Results A total of 198 patients with complete data and regularly followed-up were enrolled.They were divided into two groups:50(25.25%)patients in non-response group and 148(74.75%)in response group.There was no significant difference between two groups in responsive rate under various common induction therapies.And then,the risk factors influencing the curative effects of class LN Ⅳ patients were further explored.Results showed that the nonresponse group had a higher rate of photosensitization,renal dysfunction,moderate proteinuria,the anti-RNP positive,renal glomerular sclerosis,CI,chronic interstitial lesions,interstitial cellular infiltration and NNV than in the response group(P<0.05).Kaplan-Meier results showed that a decreasing response happened in the group with a higher rate of renal dysfunction,chronic lesions and interstitial cellular infiltration(Log Rank P<0.05).Then multivariate COX regression model investigated that renal dysfunction was an independent risk factor for poor curative effect.Conclusions Under the treatment of common induction therapy,the classⅣ LN patients with baseline renal dysfunction have a terrible curative effect.In addition,it is possible that the baseline anti-RNP positivity,chronic interstitial lesions,interstitial cellular infiltration or NNV are the risk factors for unresponsive treatment.
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spelling doaj-art-fd67e6063eda4ab4b8012dc03ba4cdc72025-08-20T03:09:27ZzhoEditorial Department of Journal of Clinical NephrologyLinchuang shenzangbing zazhi1671-23902017-01-0126527057916920Risk factors influencing curative effect of class Ⅳ lupus nephritisZHANG Yu-rongQI Yuan-yuanMA XiaoMENG Rui-xiaYANG YanWANG JingObjective To investigate the clinical risk factors for unresponsive common approaches on the treatment of class IV lupus nephritis(LN).Methods The class IV LN patients were confirmed by renal biopsy,treated with glucocorticoid and common immunosuppressive agents and followed up for more than6 months.They were divided into two groups according to curative effect after treatment for 6months.The differences between the two groups were analyzed by means of demographic characteristics,clinical manifestations,laboratory tests,autoantibodies,pathologic indicators,treatment regimens and outcomes.The possible influencing risk factors on the classⅣ LN were analyzed by Kaplan-Meier,and the independent risk factors were analyzed by multivariate COX regression modeling.Results A total of 198 patients with complete data and regularly followed-up were enrolled.They were divided into two groups:50(25.25%)patients in non-response group and 148(74.75%)in response group.There was no significant difference between two groups in responsive rate under various common induction therapies.And then,the risk factors influencing the curative effects of class LN Ⅳ patients were further explored.Results showed that the nonresponse group had a higher rate of photosensitization,renal dysfunction,moderate proteinuria,the anti-RNP positive,renal glomerular sclerosis,CI,chronic interstitial lesions,interstitial cellular infiltration and NNV than in the response group(P<0.05).Kaplan-Meier results showed that a decreasing response happened in the group with a higher rate of renal dysfunction,chronic lesions and interstitial cellular infiltration(Log Rank P<0.05).Then multivariate COX regression model investigated that renal dysfunction was an independent risk factor for poor curative effect.Conclusions Under the treatment of common induction therapy,the classⅣ LN patients with baseline renal dysfunction have a terrible curative effect.In addition,it is possible that the baseline anti-RNP positivity,chronic interstitial lesions,interstitial cellular infiltration or NNV are the risk factors for unresponsive treatment.http://www.lcszb.com/thesisDetails?columnId=57916920&Fpath=home&index=0Systemic lupus erythematosisLupus nephritisInduction therapyRisk factors
spellingShingle ZHANG Yu-rong
QI Yuan-yuan
MA Xiao
MENG Rui-xia
YANG Yan
WANG Jing
Risk factors influencing curative effect of class Ⅳ lupus nephritis
Linchuang shenzangbing zazhi
Systemic lupus erythematosis
Lupus nephritis
Induction therapy
Risk factors
title Risk factors influencing curative effect of class Ⅳ lupus nephritis
title_full Risk factors influencing curative effect of class Ⅳ lupus nephritis
title_fullStr Risk factors influencing curative effect of class Ⅳ lupus nephritis
title_full_unstemmed Risk factors influencing curative effect of class Ⅳ lupus nephritis
title_short Risk factors influencing curative effect of class Ⅳ lupus nephritis
title_sort risk factors influencing curative effect of class iv lupus nephritis
topic Systemic lupus erythematosis
Lupus nephritis
Induction therapy
Risk factors
url http://www.lcszb.com/thesisDetails?columnId=57916920&Fpath=home&index=0
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