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Clinical outcomes of childhood lupus nephritis: a single center's experience

Cited 47 time in Web of Science Cited 59 time in Scopus
Authors
Lee, Byong Sop; Cho, Hee Yeon; Kim, Eo Jin; Kang, Hee Gyung; Ha, Il Soo; Cheong, Hae Il; Kim, Joong Gon; Lee, Hyun Soon; Choi, Yong
Issue Date
2006-11-30
Publisher
Springer Verlag
Citation
Pediatr Nephrol. 2007 Feb;22(2):222-31. Epub 2006 Nov 28.
Keywords
AdolescentAntiphospholipid Syndrome/diagnosis/etiologyChildChild, PreschoolDisease ProgressionFemaleHumansImmunosuppressive Agents/therapeutic useKaplan-Meiers EstimateKidney Failure, Chronic/diagnosis/etiologyKoreaLupus Nephritis/*complications/*diagnosis/drug therapy/mortalityMalePrognosisRetrospective StudiesRisk FactorsSurvival Rate
Abstract
This study retrospectively reviewed the medical records of children with lupus nephritis (LN) who were treated at Seoul National University Children's Hospital from 1986 to 2005 (mean duration 8.3+/-4.4 years). The records of 77 children (22 male and 55 female) were examined. The mean age at diagnosis was 11.9+/-3.0 years. The initial biopsy results revealed a WHO class IV classification for 60 (88.2%) of 68 biopsy proven cases. Of 77 patients, 67 (87.0%) responded initially to the high-dose corticosteroids with or without additional immunosuppressive therapy. Of the initial responders (67), 30 (44.8%) experienced at least one episode of proteinuric (24) or nephritic (6) flare. Thirteen patients (16.9%) progressed to either chronic renal failure (CRF) or end-stage renal disease (ESRD). Six (7.8%) patients died. A Kaplan-Meier estimate of patient survival and CRF-free survival rate was 95.4% and 88.7% at 5 years and 91.8% and 74.7% at 10 years, respectively. Multivariate analysis for class IV LN revealed male gender (P=0.029), initial hypertension (P=0.001) and absence of remission (P=0.002) to be prognostic factors predicting CRF. Glomerulosclerosis of 10% or more (P=0.005), nephritic flare (P=0.011), and presence of anti-phospholipid antibody (P=0.017) or syndrome (P=0.004) were also found to be independent risk factors for CRF. Cyclophosphamide pulse therapy failed to demonstrate superiority over other combined immunosuppressants used for the treatment of diffuse proliferative LN.
ISSN
0931-041X (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17131162

http://hdl.handle.net/10371/22854
DOI
https://doi.org/10.1007/s00467-006-0286-0
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College of Medicine/School of Medicine (의과대학/대학원)Pediatrics (소아과학전공)Journal Papers (저널논문_소아과학전공)
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