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Time to renal disease and end-stage renal disease in PROFILE: a multiethnic lupus cohort.

Abstract：

BACKGROUND: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). METHODS AND FINDINGS: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. CONCLUSIONS: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.

journal_name

PLoS Med

journal_title

PLoS medicine

authors

Alarcón GS,McGwin G Jr,Petri M,Ramsey-Goldman R,Fessler BJ,Vilá LM,Edberg JC,Reveille JD,Kimberly RP,PROFILE Study Group.

doi

10.1371/journal.pmed.0030396

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

e396

issue

eissn

1549-1277

issn

1549-1676

pii

06-PLME-RA-0027R2

journal_volume

pub_type

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Time to renal disease and end-stage renal disease in PROFILE: a multiethnic lupus cohort.