Abstract
To identify and reclassify the patients in the lupus nephritis (LN) cohort, and to further analyze the prominent clinical features and clinical significance of each cluster. In this retrospective cross-sectional study, we used atwo-step clustering method to classify 635 patients with LN into different clusters, then we observed the main differences and analyzed relevant clinical significance between the clusters. Cluster1 (20.5%) presented with the highest disease severity, patients in this group had the disease for alonger duration and higher systemic lupus erythematosus disease activity index (SLEDAI) score, with multiple positive auto-antibodies and lower complement level. Patients of cluster2 (20.8%) had lower levels of IgG, IgA and IgM, with renal function being relatively worse in this cluster than in clusters1 and3. Cluster3 was the largest group (58.7%), and the patients in this group showed mild disease severity. This study reclassified LN patients in alarge cohort into three clusters. Our classification might be helpful to implement targeted therapy at various stages of systemic lupus erythematosus.
Highlights
Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organs, renal involvement will significantly increase the morbidity and mortality of SLE.[1]
Our research shows that the multiple positive antinuclear antibodies (ANA) antibody may be related to the high SLICC/ACR Damage Index (SDI) score of lupus nephritis (LN) patients
The current measure system used to assess damage to SLE is the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI),[3] and the basic disease assessment system for LN is the 2003 International Society of Nephrology/ Renal Pathology Society (ISN/RPS) classification system,[4, 5] clinicians could apply targeted treatment strategies for patients based on the above disease assessment classifications.[6]
Summary
Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organs, renal involvement will significantly increase the morbidity and mortality of SLE.[1]. The current measure system used to assess damage to SLE is the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI),[3] and the basic disease assessment system for LN is the 2003 International Society of Nephrology/ Renal Pathology Society (ISN/RPS) classification system,[4, 5] clinicians could apply targeted treatment strategies for patients based on the above disease assessment classifications.[6] Despite this, 10–30% of patients with LN will progress to ESRD within 15 years of diagnosis.[7] Thence, it indicates that the classification of LN could be improved by incorporating clinical indices and pathological features to evaluate the condition of LN patients
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