Prevalence of biopsy proven Lupus Nephritis and outcomes of their treatments in tertiary center in Kuantan

Introduction: Lupus nephritis (LN) can lead to end stage kidney disease (ESKD) and mortality. Depending on biopsy, induction treatment includes intravenous cyclophosphamide or mycophenolate mofetil with concurrent corticosteroids with the aim to achieve clinical remission at least within 1 year post...

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Main Authors: Mohammad Isa, Muhammad Syafiq, Wan Ali, Wan Ahmad Syahril Rozli, Mohamad Nor, Fariz Safhan
Format: Article
Language:English
Published: Faculty of Medicine Universiti Kebangsaan Malaysia 2023
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Online Access:http://irep.iium.edu.my/109374/7/109374_Prevalence%20of%20biopsy%20proven%20Lupus%20Nephritis.pdf
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spelling my.iium.irep.1093742023-12-28T04:55:08Z http://irep.iium.edu.my/109374/ Prevalence of biopsy proven Lupus Nephritis and outcomes of their treatments in tertiary center in Kuantan Mohammad Isa, Muhammad Syafiq Wan Ali, Wan Ahmad Syahril Rozli Mohamad Nor, Fariz Safhan R Medicine (General) RC Internal medicine Introduction: Lupus nephritis (LN) can lead to end stage kidney disease (ESKD) and mortality. Depending on biopsy, induction treatment includes intravenous cyclophosphamide or mycophenolate mofetil with concurrent corticosteroids with the aim to achieve clinical remission at least within 1 year post treatment. This study aims to investigate the prevalence of biopsy proven LN in Hospital Tengku Ampuan Afzan (HTAA) and the outcomes of treatments. Materials and Methods: Retrospective cohort study was conducted among all renal biopsies done in HTAA from 2010 to 2021. Demographic data, clinical presentations, remission status at 1 year and outcomes of treatments were analysed. Cox regression analysis and Kaplan-Meier curve were used respectively to determine the associated risk factors and the rate of progression to ESKD and mortality. Results: There was a total of 177 biopsy proven LN patients from 460 biopsies done making the prevalence of biopsy proven LN in HTAA to be 38.5%. Majority of them were Malays (84.7%), females (89.8%) and less than 40-year-old (85.4%). LN class IV was the commonest presentation (37.9%) and only 9.0% of patients required hemodialysis upon presentation. Renal survival rates at 5- and 10-year of treatment were 92.7% and 90.1% respectively and survival rates at 5- and 10-year of treatment were 85.0% and 80.0% respectively. Hemodialysis requirement upon presentation was associated with progression to ESKD (HR: 5.102, 95% CI: 1.645-15.826, P=0.005) meanwhile treatment compliance was associated with mortality (HR:0.153, 95% CI: 0.0041-0.566, P=0.005). Race, age, gender, LN class and remission status at 1 year post treatment were not associated with poor outcomes. Conclusion: Prevalence of biopsy proven LN in our study is low compared to other studies. Our study had shown higher renal survival rate at 5- and 10-year and lower survival rate at 5- and 10-year. Hemodialysis requirement upon presentation and treatment compliance were associated with poor outcomes. Faculty of Medicine Universiti Kebangsaan Malaysia 2023-12 Article PeerReviewed application/pdf en http://irep.iium.edu.my/109374/7/109374_Prevalence%20of%20biopsy%20proven%20Lupus%20Nephritis.pdf Mohammad Isa, Muhammad Syafiq and Wan Ali, Wan Ahmad Syahril Rozli and Mohamad Nor, Fariz Safhan (2023) Prevalence of biopsy proven Lupus Nephritis and outcomes of their treatments in tertiary center in Kuantan. Medicine & Health, 18 (7 (Suppl)). p. 19. E-ISSN 2289-5728 https://www.medicineandhealthukm.com/ibrowser https://doi.org/10.17576/MH.2023.s1807
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
topic R Medicine (General)
RC Internal medicine
spellingShingle R Medicine (General)
RC Internal medicine
Mohammad Isa, Muhammad Syafiq
Wan Ali, Wan Ahmad Syahril Rozli
Mohamad Nor, Fariz Safhan
Prevalence of biopsy proven Lupus Nephritis and outcomes of their treatments in tertiary center in Kuantan
description Introduction: Lupus nephritis (LN) can lead to end stage kidney disease (ESKD) and mortality. Depending on biopsy, induction treatment includes intravenous cyclophosphamide or mycophenolate mofetil with concurrent corticosteroids with the aim to achieve clinical remission at least within 1 year post treatment. This study aims to investigate the prevalence of biopsy proven LN in Hospital Tengku Ampuan Afzan (HTAA) and the outcomes of treatments. Materials and Methods: Retrospective cohort study was conducted among all renal biopsies done in HTAA from 2010 to 2021. Demographic data, clinical presentations, remission status at 1 year and outcomes of treatments were analysed. Cox regression analysis and Kaplan-Meier curve were used respectively to determine the associated risk factors and the rate of progression to ESKD and mortality. Results: There was a total of 177 biopsy proven LN patients from 460 biopsies done making the prevalence of biopsy proven LN in HTAA to be 38.5%. Majority of them were Malays (84.7%), females (89.8%) and less than 40-year-old (85.4%). LN class IV was the commonest presentation (37.9%) and only 9.0% of patients required hemodialysis upon presentation. Renal survival rates at 5- and 10-year of treatment were 92.7% and 90.1% respectively and survival rates at 5- and 10-year of treatment were 85.0% and 80.0% respectively. Hemodialysis requirement upon presentation was associated with progression to ESKD (HR: 5.102, 95% CI: 1.645-15.826, P=0.005) meanwhile treatment compliance was associated with mortality (HR:0.153, 95% CI: 0.0041-0.566, P=0.005). Race, age, gender, LN class and remission status at 1 year post treatment were not associated with poor outcomes. Conclusion: Prevalence of biopsy proven LN in our study is low compared to other studies. Our study had shown higher renal survival rate at 5- and 10-year and lower survival rate at 5- and 10-year. Hemodialysis requirement upon presentation and treatment compliance were associated with poor outcomes.
format Article
author Mohammad Isa, Muhammad Syafiq
Wan Ali, Wan Ahmad Syahril Rozli
Mohamad Nor, Fariz Safhan
author_facet Mohammad Isa, Muhammad Syafiq
Wan Ali, Wan Ahmad Syahril Rozli
Mohamad Nor, Fariz Safhan
author_sort Mohammad Isa, Muhammad Syafiq
title Prevalence of biopsy proven Lupus Nephritis and outcomes of their treatments in tertiary center in Kuantan
title_short Prevalence of biopsy proven Lupus Nephritis and outcomes of their treatments in tertiary center in Kuantan
title_full Prevalence of biopsy proven Lupus Nephritis and outcomes of their treatments in tertiary center in Kuantan
title_fullStr Prevalence of biopsy proven Lupus Nephritis and outcomes of their treatments in tertiary center in Kuantan
title_full_unstemmed Prevalence of biopsy proven Lupus Nephritis and outcomes of their treatments in tertiary center in Kuantan
title_sort prevalence of biopsy proven lupus nephritis and outcomes of their treatments in tertiary center in kuantan
publisher Faculty of Medicine Universiti Kebangsaan Malaysia
publishDate 2023
url http://irep.iium.edu.my/109374/7/109374_Prevalence%20of%20biopsy%20proven%20Lupus%20Nephritis.pdf
http://irep.iium.edu.my/109374/
https://www.medicineandhealthukm.com/ibrowser
https://doi.org/10.17576/MH.2023.s1807
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