Time to renal disease and end-stage renal disease in PROFILE: a multiethnic lupus cohort.
Renal involvement is a serious manifestation of systemic lupus erythematosus (SLE); it may portend a poor prognosis as it may lead to end-stage renal disease (ESRD). The purpose of this study was to determine the factors predicting the development of renal involvement and its progression to ESRD in...
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2006-10-01
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doaj-de6c5e200ff84882a654c5452843b21b2020-11-25T01:38:40ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762006-10-01310e39610.1371/journal.pmed.0030396Time to renal disease and end-stage renal disease in PROFILE: a multiethnic lupus cohort.Graciela S AlarcónGerald McGwinMichelle PetriRosalind Ramsey-GoldmanBarri J FesslerLuis M ViláJeffrey C EdbergJohn D ReveilleRobert P KimberlyPROFILE Study GroupRenal involvement is a serious manifestation of systemic lupus erythematosus (SLE); it may portend a poor prognosis as it may lead to end-stage renal disease (ESRD). The purpose of this study was to determine the factors predicting the development of renal involvement and its progression to ESRD in a multi-ethnic SLE cohort (PROFILE).PROFILE includes SLE patients from five different United States institutions. We examined at baseline the socioeconomic-demographic, clinical, and genetic variables associated with the development of renal involvement and its progression to ESRD by univariable and multivariable Cox proportional hazards regression analyses. Analyses of onset of renal involvement included only patients with renal involvement after SLE diagnosis (n = 229). Analyses of ESRD included all patients, regardless of whether renal involvement occurred before, at, or after SLE diagnosis (34 of 438 patients). In addition, we performed a multivariable logistic regression analysis of the variables associated with the development of renal involvement at any time during the course of SLE. In the time-dependent multivariable analysis, patients developing renal involvement were more likely to have more American College of Rheumatology criteria for SLE, and to be younger, hypertensive, and of African-American or Hispanic (from Texas) ethnicity. Alternative regression models were consistent with these results. In addition to greater accrued disease damage (renal damage excluded), younger age, and Hispanic ethnicity (from Texas), homozygosity for the valine allele of FcgammaRIIIa (FCGR3A*GG) was a significant predictor of ESRD. Results from the multivariable logistic regression model that included all cases of renal involvement were consistent with those from the Cox model.Fcgamma receptor genotype is a risk factor for progression of renal disease to ESRD. Since the frequency distribution of FCGR3A alleles does not vary significantly among the ethnic groups studied, the additional factors underlying the ethnic disparities in renal disease progression remain to be elucidated.http://europepmc.org/articles/PMC1626549?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Graciela S Alarcón Gerald McGwin Michelle Petri Rosalind Ramsey-Goldman Barri J Fessler Luis M Vilá Jeffrey C Edberg John D Reveille Robert P Kimberly PROFILE Study Group |
spellingShingle |
Graciela S Alarcón Gerald McGwin Michelle Petri Rosalind Ramsey-Goldman Barri J Fessler Luis M Vilá Jeffrey C Edberg John D Reveille Robert P Kimberly PROFILE Study Group Time to renal disease and end-stage renal disease in PROFILE: a multiethnic lupus cohort. PLoS Medicine |
author_facet |
Graciela S Alarcón Gerald McGwin Michelle Petri Rosalind Ramsey-Goldman Barri J Fessler Luis M Vilá Jeffrey C Edberg John D Reveille Robert P Kimberly PROFILE Study Group |
author_sort |
Graciela S Alarcón |
title |
Time to renal disease and end-stage renal disease in PROFILE: a multiethnic lupus cohort. |
title_short |
Time to renal disease and end-stage renal disease in PROFILE: a multiethnic lupus cohort. |
title_full |
Time to renal disease and end-stage renal disease in PROFILE: a multiethnic lupus cohort. |
title_fullStr |
Time to renal disease and end-stage renal disease in PROFILE: a multiethnic lupus cohort. |
title_full_unstemmed |
Time to renal disease and end-stage renal disease in PROFILE: a multiethnic lupus cohort. |
title_sort |
time to renal disease and end-stage renal disease in profile: a multiethnic lupus cohort. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS Medicine |
issn |
1549-1277 1549-1676 |
publishDate |
2006-10-01 |
description |
Renal involvement is a serious manifestation of systemic lupus erythematosus (SLE); it may portend a poor prognosis as it may lead to end-stage renal disease (ESRD). The purpose of this study was to determine the factors predicting the development of renal involvement and its progression to ESRD in a multi-ethnic SLE cohort (PROFILE).PROFILE includes SLE patients from five different United States institutions. We examined at baseline the socioeconomic-demographic, clinical, and genetic variables associated with the development of renal involvement and its progression to ESRD by univariable and multivariable Cox proportional hazards regression analyses. Analyses of onset of renal involvement included only patients with renal involvement after SLE diagnosis (n = 229). Analyses of ESRD included all patients, regardless of whether renal involvement occurred before, at, or after SLE diagnosis (34 of 438 patients). In addition, we performed a multivariable logistic regression analysis of the variables associated with the development of renal involvement at any time during the course of SLE. In the time-dependent multivariable analysis, patients developing renal involvement were more likely to have more American College of Rheumatology criteria for SLE, and to be younger, hypertensive, and of African-American or Hispanic (from Texas) ethnicity. Alternative regression models were consistent with these results. In addition to greater accrued disease damage (renal damage excluded), younger age, and Hispanic ethnicity (from Texas), homozygosity for the valine allele of FcgammaRIIIa (FCGR3A*GG) was a significant predictor of ESRD. Results from the multivariable logistic regression model that included all cases of renal involvement were consistent with those from the Cox model.Fcgamma receptor genotype is a risk factor for progression of renal disease to ESRD. Since the frequency distribution of FCGR3A alleles does not vary significantly among the ethnic groups studied, the additional factors underlying the ethnic disparities in renal disease progression remain to be elucidated. |
url |
http://europepmc.org/articles/PMC1626549?pdf=render |
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