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Carlucci, Philip M; Li, Jessica; Fava, Andrea; Deonaraine, Kristina K; Wofsy, David; James, Judith A; Putterman, Chaim; Diamond, Betty; Davidson, Anne; Fine, Derek M; Monroy-Trujillo, Jose; Atta, Mohamed G; DeJager, Wade; Guthridge, Joel M; Haag, Kristin; Rao, Deepak A; Brenner, Michael B; Lederer, James A; Apruzzese, William; Belmont, H Michael; Izmirly, Peter M; Zaminski, Devyn; Wu, Ming; Connery, Sean; [...]

High incidence of proliferative and membranous nephritis in SLE patients with low proteinuria in the Accelerating Medicines Partnership

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  • Medientyp: E-Artikel
  • Titel: High incidence of proliferative and membranous nephritis in SLE patients with low proteinuria in the Accelerating Medicines Partnership
  • Beteiligte: Carlucci, Philip M; Li, Jessica; Fava, Andrea; Deonaraine, Kristina K; Wofsy, David; James, Judith A; Putterman, Chaim; Diamond, Betty; Davidson, Anne; Fine, Derek M; Monroy-Trujillo, Jose; Atta, Mohamed G; DeJager, Wade; Guthridge, Joel M; Haag, Kristin; Rao, Deepak A; Brenner, Michael B; Lederer, James A; Apruzzese, William; Belmont, H Michael; Izmirly, Peter M; Zaminski, Devyn; Wu, Ming; Connery, Sean; [...]
  • Erschienen: Oxford University Press (OUP), 2022
  • Erschienen in: Rheumatology
  • Sprache: Englisch
  • DOI: 10.1093/rheumatology/keac067
  • ISSN: 1462-0324; 1462-0332
  • Schlagwörter: Pharmacology (medical) ; Rheumatology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>Delayed detection of LN associates with worse outcomes. There are conflicting recommendations regarding a threshold level of proteinuria at which biopsy will likely yield actionable management. This study addressed the association of urine protein:creatinine ratios (UPCR) with clinical characteristics and investigated the incidence of proliferative and membranous histology in patients with a UPCR between 0.5 and 1.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A total of 275 SLE patients (113 first biopsy, 162 repeat) were enrolled in the multicentre multi-ethnic/racial Accelerating Medicines Partnership across 15 US sites at the time of a clinically indicated renal biopsy. Patients were followed for 1 year.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>At biopsy, 54 patients had UPCR &amp;lt;1 and 221 had UPCR ≥1. Independent of UPCR or biopsy number, a majority (92%) of patients had class III, IV, V or mixed histology. Moreover, patients with UPCR &amp;lt;1 and class III, IV, V, or mixed had a median activity index of 4.5 and chronicity index of 3, yet 39% of these patients had an inactive sediment. Neither anti-dsDNA nor low complement distinguished class I or II from III, IV, V or mixed in patients with UPCR &amp;lt;1. Of 29 patients with baseline UPCR &amp;lt;1 and class III, IV, V or mixed, 23 (79%) had a UPCR &amp;lt;0.5 at 1 year.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>In this prospective study, three-quarters of patients with UPCR &amp;lt;1 had histology showing class III, IV, V or mixed with accompanying activity and chronicity despite an inactive sediment or normal serologies. These data support renal biopsy at thresholds lower than a UPCR of 1.</jats:p></jats:sec>
  • Zugangsstatus: Freier Zugang