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Decreased incidence of lupus nephritis in northern Norway is linked to increased use of antihypertensive and anticoagulant therapy.
MedLine Citation:
PMID:  20647194     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
METHODS: This is an observational study of two subsequent SLE inception cohorts based on 1982 American College of Rheumatology (acr) classification criteria (82acr; n = 87, enrolled 1978-95) and the updated version in 1997 (97acr: n = 62, enrolled 1996-2006). Annual incidence rates (AIR), point prevalence, clinical and histological features, and outcome of LN (defined as proteinuria with urinary casts and/or haematuria) were compared between both cohorts.
RESULTS: Between 1978 and 2006, the AIR for LN decreased from 0.7 to 0.45/100 000, while LN prevalence rose from 7 to 14/100 000. The relative risk reduction in the 97acr for early- and late-onset LN (> 3 months after SLE diagnosis) was 39% and 42%, respectively. Patients developing LN in the 97acr cohort (97LN +; n = 11) had similar demographics, more often low avidity anti-dsDNA antibodies (Ab) and/or anti-cardiolipin Ab at SLE diagnosis, lower proteinuria and diastolic blood pressure, and similar histological findings to those in the 83acr cohort (82LN +; n = 28). Following LN diagnosis, more 97LN + patients received pulse corticosteroids (55% vs. 7%), anticoagulants (46% vs. 4%) and antihypertensive drugs (46% vs. 11%). Three 82LN + patients (11%) developed end-stage renal disease versus none in 97LN + during a 10-year follow-up.
CONCLUSIONS: Early detection of low avidity anti-dsDNA and antiphospholipid antibodies, probably in combination with early use of protective cardiovascular measures from SLE diagnosis onwards may contribute to reduced incidence and improved renal survival in LN.
Authors:
Gro Østli Eilertsen; Silje Fismen; Tor-Arne Hanssen; Johannes C Nossent
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Publication Detail:
Type:  Journal Article     Date:  2010-07-19
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  26     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  620-7     Citation Subset:  IM    
Affiliation:
Correspondence and offprint requests to: Gro Østli Eilertsen; E-mail: gro.ostli.eilertsen@unn.no.
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