S-Space College of Medicine/School of Medicine (의과대학/대학원) Pediatrics (소아과학전공) Journal Papers (저널논문_소아과학전공)
Clinical outcomes of childhood lupus nephritis: a single center's experience
- 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
- Springer Verlag
- Pediatr Nephrol. 2007 Feb;22(2):222-31. Epub 2006 Nov 28.
- Adolescent; Antiphospholipid Syndrome/diagnosis/etiology; Child; Child, Preschool; Disease Progression; Female; Humans; Immunosuppressive Agents/therapeutic use; Kaplan-Meiers Estimate; Kidney Failure, Chronic/diagnosis/etiology; Korea; Lupus Nephritis/*complications/*diagnosis/drug therapy/mortality; Male; Prognosis; Retrospective Studies; Risk Factors; Survival Rate
- 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.
- 0931-041X (Print)
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