Abstract: TH-PO624
Factors Predictive of Infections over Time in Lupus Nephritis Patients: Data from a Single-Center Retrospective Cohort
Session Information
- Glomerular Diseases: Clinical and Epidemiologic Studies
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Zhang, Wenhao, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
- Ye, Zhiming, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
Background
Infection is a common complication among patients with lupus nephritis (LN) who started treatment. Previous studies have shown that infection has become the leading cause of death in patients with LN. Therefore, early identification of risk factors for infection in LN patients is of great significance for complication prevention and improvement of prognosis. The aim of this study was to explore the clinical predictors of infection in patients with LN.
Methods
Patients who were diagnosed with LN and treated with immunosuppressive therapy at Guangdong Provincial People’s Hospital from 2000 to 2020 were enrolled. Demographics, laboratory data, glucocorticoid dosage, antimalarial usage, immunosuppressive agents and infection details were included. Cox regression model was adopted to identify risk factors of infection. Both Univariable and multivariable analyses were performed.
Results
1. A total of 374 LN patients were enrolled, of which 85.3% (n=319) were female. The average age was 30±12 years and the age ranged from 5 to 81 years. The mean of height was 1.58±0.99m and weight was 51.62±9.87kg. 219 patients (58.6%) with LN developed infection during follow-up, of which 111 (29.7%) were severe infection.
2. In order to compare changes of variables from 3 months, 6months and 12months after treatment, our study conducted cox regression analysis. We also conducted ROC and showed the AUC respectively (0.798, 0.700 and 0.521). Multivariable analysis demonstrated that IgM (HR=1.288，95%Cl：1.074-1.544，p=0.006)and free light chain λ (HR=1.783，95%Cl：1.000-3.177，p=0.050) were predictive factors of infection while after 3month treatment , anti-dsDNA reduction(HR=0.728，95%Cl：0.563-0.924，p=0.016) and hemoglobin increase(HR=0.790，95%Cl：0.652-0.958，p=0.017) were protective.
Conclusion
Our study showed that the incidence of infection in LN patients during treatment was high. Changes of variables in 3months after treatment had the most significant influence on infection and severe infection. High levels of IgM and serum free light chain λbefore treatment increase the risk of infection and dsDNA antibodies decreased and hemoglobin increased at the third month of treatment, were protective
Funding
- NIDDK Support