Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis
Objective To evaluate the performance of the European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) SLE classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis (LN) and their renal prognosis.Methods Patients with newly diagnosed SLE attending an...
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Format: | Article |
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BMJ Publishing Group
2021-09-01
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Series: | Lupus Science and Medicine |
Online Access: | https://lupus.bmj.com/content/8/1/e000458.full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Fei Han Lan Lan Yanhong Ma Huijing Wang Yunjie Gao Fanghao Cai Xiaohan Huang Pingping Ren Yaomin Wang |
spellingShingle |
Fei Han Lan Lan Yanhong Ma Huijing Wang Yunjie Gao Fanghao Cai Xiaohan Huang Pingping Ren Yaomin Wang Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis Lupus Science and Medicine |
author_facet |
Fei Han Lan Lan Yanhong Ma Huijing Wang Yunjie Gao Fanghao Cai Xiaohan Huang Pingping Ren Yaomin Wang |
author_sort |
Fei Han |
title |
Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis |
title_short |
Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis |
title_full |
Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis |
title_fullStr |
Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis |
title_full_unstemmed |
Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis |
title_sort |
performance of the 2019 eular/acr systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis |
publisher |
BMJ Publishing Group |
series |
Lupus Science and Medicine |
issn |
2053-8790 |
publishDate |
2021-09-01 |
description |
Objective To evaluate the performance of the European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) SLE classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis (LN) and their renal prognosis.Methods Patients with newly diagnosed SLE attending and followed up for >12 months were included. A retrospective review of all patients with renal biopsy fulfilling a consensus expert opinion during 2014 and 2018. Clinical, serological and pathological data were collected and each patient was assigned a high/low criteria scores (HS/LS) group. Survival curves for flare adjusted for multiplicity on renal flares, was applied to the two groups.Results Applying EULAR/ACR criteria in our cohort of 126 patients, 6 (4.76%) did not meet the criterion, resulting in a sensitivity of 95.24%. The EULAR/ACR criteria scores was positively correlated with SLE disease activity index scores. Additionally, we noticed that a significant difference in clinical and immunological manifestations between HS and LS group. We observed a higher proportions of class Ⅲ or Ⅳ LN and lower proportions of class Ⅱ or V LN (p=0.034) and pathological higher activity index in HS group (p=0.007). Compared with LS groups, patients involved more severe renal damage and achieved higher rate of complete remission in the HS group. The Kaplan-Meier exploratory analyses, adjusted for LN classification, estimated glomerular filtration rate, activity index and chronicity index and induction and maintenance treatments, showed that patients in the HS group had a tendency of higher renal flare risk than that in the LS group (HR=0.21, p=0.04).Conclusions The EULAR/ACR criteria performed high sensitivity in identifying SLE in this cohort of biopsy-confirmed LN. Patients with LN with high criteria scores had more extrarenal manifestations, and worse renal prognosis in the short and long terms. |
url |
https://lupus.bmj.com/content/8/1/e000458.full |
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doaj-42b10cb879d44c8794274080e3be1d5c2021-09-21T00:30:03ZengBMJ Publishing GroupLupus Science and Medicine2053-87902021-09-018110.1136/lupus-2020-000458Performance of the 2019 EULAR/ACR systemic lupus erythematosus classification criteria in a cohort of patients with biopsy-confirmed lupus nephritisFei Han0Lan Lan1Yanhong Ma2Huijing Wang3Yunjie Gao4Fanghao Cai5Xiaohan Huang6Pingping Ren7Yaomin Wang8Kidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaKidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital; Institute of Nephrology, Zhejiang University; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, ChinaObjective To evaluate the performance of the European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) SLE classification criteria in a cohort of patients with biopsy-confirmed lupus nephritis (LN) and their renal prognosis.Methods Patients with newly diagnosed SLE attending and followed up for >12 months were included. A retrospective review of all patients with renal biopsy fulfilling a consensus expert opinion during 2014 and 2018. Clinical, serological and pathological data were collected and each patient was assigned a high/low criteria scores (HS/LS) group. Survival curves for flare adjusted for multiplicity on renal flares, was applied to the two groups.Results Applying EULAR/ACR criteria in our cohort of 126 patients, 6 (4.76%) did not meet the criterion, resulting in a sensitivity of 95.24%. The EULAR/ACR criteria scores was positively correlated with SLE disease activity index scores. Additionally, we noticed that a significant difference in clinical and immunological manifestations between HS and LS group. We observed a higher proportions of class Ⅲ or Ⅳ LN and lower proportions of class Ⅱ or V LN (p=0.034) and pathological higher activity index in HS group (p=0.007). Compared with LS groups, patients involved more severe renal damage and achieved higher rate of complete remission in the HS group. The Kaplan-Meier exploratory analyses, adjusted for LN classification, estimated glomerular filtration rate, activity index and chronicity index and induction and maintenance treatments, showed that patients in the HS group had a tendency of higher renal flare risk than that in the LS group (HR=0.21, p=0.04).Conclusions The EULAR/ACR criteria performed high sensitivity in identifying SLE in this cohort of biopsy-confirmed LN. Patients with LN with high criteria scores had more extrarenal manifestations, and worse renal prognosis in the short and long terms.https://lupus.bmj.com/content/8/1/e000458.full |