Lupus nephritis: prognostic factors in children.

Abstract:

:As newer treatment modalities become available for patients with severe lupus nephritis, it becomes increasingly important to identify patients at risk for renal failure. In this study, the records of 90 children presenting with systemic lupus erythematosus over a 13-year period were reviewed. Nineteen were lost to follow-up prior to completion of the study. Of the 71 remaining children, 16 (22%) progressed to chronic renal failure. Persistent hypertension lasting greater than 4 months, anemia, abnormalities of the urinalysis, and elevated serum creatinine level were significantly associated with progression to renal failure. Sex, race, age, abnormalities of creatinine clearance, and 24-hour urine protein collection were not associated with progression to renal failure. Renal biopsies were obtained in 45 children. Biopsies were initially classified according to World Health Organization criteria. Diffuse proliferative glomerulonephritis was significantly associated with progression to renal failure. The 45 biopsies available were reviewed by one of the authors and categorized by activity and chronicity indices. Both the active lesions of fibrinoid necrosis, synechiae, tubular casts, and vasculitic lesions and the chronic lesion of glomerular sclerosis correlated with progression to renal failure. Of the 16 children who progressed to renal failure, 2 had cadaver kidney transplants and are well 5 years posttransplant; 4 had fulminant lupus and died within 1 month of commencing dialysis; 10 began chronic dialysis. Five of the 10 children on chronic dialysis died from sepsis. These data suggest that children with systemic lupus erythematosus who undergo dialysis do poorly.(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

Pediatrics

journal_title

Pediatrics

authors

McCurdy DK,Lehman TJ,Bernstein B,Hanson V,King KK,Nadorra R,Landing BH

subject

Has Abstract

pub_date

1992-02-01 00:00:00

pages

240-6

issue

2

eissn

0031-4005

issn

1098-4275

journal_volume

89

pub_type

杂志文章
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    更新日期:2013-10-01 00:00:00

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    更新日期:2001-03-01 00:00:00

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    pub_type: 杂志文章

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    authors: Committee on Child Abuse and Neglect.

    更新日期:2010-01-01 00:00:00

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    更新日期:2011-04-01 00:00:00

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Stanley CA,Baker L

    更新日期:1976-05-01 00:00:00

  • Early-onset group B streptococcal disease in the era of maternal screening.

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    更新日期:2005-05-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1542/peds.2016-1990

    authors: Draper ES,Manktelow BN,Cuttini M,Maier RF,Fenton AC,Van Reempts P,Bonamy AK,Mazela J,Bᴓrch K,Koopman-Esseboom C,Varendi H,Barros H,Zeitlin JJ,EPICE Cohort.

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    pub_type: 杂志文章,评审

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    authors: Rothermel H,Hedges TR 3rd,Steere AC

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    pub_type: 杂志文章

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  • Retinopathy of prematurity-induced blindness: birth weight-specific survival and the new epidemic.

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    journal_title:Pediatrics

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    doi:

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    更新日期:1990-09-01 00:00:00

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    journal_title:Pediatrics

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    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

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    更新日期:1989-07-01 00:00:00

  • Three-year follow-up of vaccine response in extremely preterm infants.

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    doi:

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    pub_type: 临床试验,杂志文章,随机对照试验

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    doi:

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    更新日期:1975-02-01 00:00:00

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    journal_title:Pediatrics

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    pub_type: 杂志文章

    doi:

    authors:

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