An assessment of renal failure in an SLE cohort with special reference to ethnicity, over a 25-year period

Rheumatology
M AdlerD A Isenberg

Abstract

Although the prognosis for patients with renal lupus has improved, a small number still progress to renal failure. Studies from the USA have found it difficult to distinguish whether the higher rate of renal failure in African-Americans is due to genetic or socio-economic factors. Our aim was to identify ethnic and other factors in a UK lupus cohort that contribute to renal failure. The University College London (UCL) Hospitals lupus cohort of 401 patients (Whites 64%, Blacks 19%), followed since 1978, has 127 patients with renal disease, of whom 21 have gone into renal failure. We determined the characteristics and possible causes of renal failure in this group. Black patients were disproportionately represented in the renal failure group (62% vs 19% for Whites). Those in the renal failure group had persistently low C3 compared with the renal disease cohort. A high proportion of patients in the renal failure group were felt to be non-adherent to treatment. Given that health-care for patients in the UK is free at the point of delivery, we postulate that in our cohort genetic factors rather than socio-economic status are likely to be more significant in causing renal failure. However, there may be cultural and other reasons for ...Continue Reading

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Citations

Nov 19, 2013·Best Practice & Research. Clinical Rheumatology·Nathalie Costedoat-ChalumeauJean-Charles Piette
Feb 1, 2008·Nature Clinical Practice. Rheumatology·Michelle M A Fernando, David A Isenberg
Dec 7, 2011·Stem Cell Research & Therapy·Tayaramma ThatavaYasuhiro Ikeda
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Nov 26, 2013·Reumatología clinica·Dafhne Miranda-HernándezMiguel Angel Saavedra
May 15, 2015·Expert Review of Clinical Immunology·Eleana Ntatsaki, David Isenberg
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Jan 3, 2013·Clinical Immunology : the Official Journal of the Clinical Immunology Society·João Furtado, David A Isenberg
Jun 1, 2012·Kidney International Supplements
Jul 14, 2009·Best Practice & Research. Clinical Rheumatology·Kanta KumarCaroline Gordon
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