Something new about prognostic factors for lupus nephritis? A systematic review

Lupus ◽  
2021 ◽  
pp. 096120332110614
Author(s):  
Esther Rodríguez-Almaraz ◽  
Elena Gutiérrez-Solís ◽  
Elena Rabadán ◽  
Paola Rodríguez ◽  
Loreto Carmona ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Prognostic Factors ◽  
Kidney Disease ◽  
Lupus Nephritis ◽  
Predictive Factors ◽  
Cardiovascular Events ◽  
Vascular Lesions ◽  
Histological Findings ◽  
Factors Associated

Background Lupus nephritis (LN) affects 30–45% of patients with systemic lupus erythematosus (SLE) and causes great morbidity and mortality. About 10–25% of patients will develop chronic kidney disease (CKD), and it has been described a mortality of 10–20% at 10 years. The contribution of clinical and biological markers to the prediction of outcome is unclear. Objective To describe the factors, with measures of association, that predict the main outcomes of LN. Material and Methods We have conducted a systematic review. Medline, Embase, and Cochrane Library were systematic searched from inception up to Oct 2019, with a strategy that included synonyms of all targeted outcomes of LN: (kidney failure, response to treatment, cardiovascular events, and mortality). Only studies with longitudinal prospective design or with warranties of unbiased recollection of the prognostic factors, where LN was confirmed by biopsy were included. Risk of bias was assessed with the New Castle Ottawa scale. Predictive factors and their effect measures were collected from each study. Results From 1221 studies identified, 25 studies were included, of which 15 were retrospective, nine prospective, and one was a trial extension study (range from 3 months to 11 years). The main predictive factors of renal response were serum creatinine (SCr) and glomerular filtration rate C3 levels, titer of anti-C1q, and anti-dsDNA antibodies. Renal histological findings such as class type (IV or V), tubulointerstitial or vascular lesions and chronicity index were risk factors for development of chronic kidney disease. The factors associated with persistence of activity were proteinuria, anti-dsDNA, anticardiolipin, anti C1q antibodies, and complement values. The factors associated to cardiovascular events and mortality were age, smoking, amount of proteinuria, and histological findings, such as vascular lesions. Meta-analysis was precluded given the heterogeneity of designs definitions and effect measures. Conclusions Nowadays, we do not have new biomarkers that establish the renal prognosis of patients with LN. Classical clinical, renal, and histological markers are used in most studies. It is worth noting the heterogeneity of studies in the definition of renal outcomes, which complicates risk stratification in these patients.

scholarly journals The impact of social disadvantage in moderate-to-severe chronic kidney disease: an equity-focused systematic review*

2015 ◽  
Vol 31 (1) ◽  
pp. 46-56 ◽  
Author(s):  
Rachael Lisa Morton ◽  
Iryna Schlackow ◽  
Borislava Mihaylova ◽  
Natalie Dawn Staplin ◽  
Alastair Gray ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Health Insurance ◽  
Kidney Disease ◽  
Cardiovascular Events ◽  
Home Ownership ◽  
Dialysis Patients ◽  
Low Education ◽  
Severe Chronic Kidney Disease ◽  
Event Rates

Abstract It is unclear whether a social gradient in health outcomes exists for people with moderate-to-severe chronic kidney disease (CKD). We critically review the literature for evidence of social gradients in health and investigate the ‘suitability’ of statistical analyses in the primary studies. In this equity-focused systematic review among adults with moderate-to-severe CKD, factors of disadvantage included gender, race/ethnicity, religion, education, socio-economic status or social capital, occupation and place of residence. Outcomes included access to healthcare, kidney disease progression, cardiovascular events, all-cause mortality and suitability of analyses. Twenty-four studies in the pre-dialysis population and 34 in the dialysis population representing 8.9 million people from 10 countries were included. In methodologically suitable studies among pre-dialysis patients, a significant social gradient was observed in access to healthcare for those with no health insurance and no home ownership. Low income and no home ownership were associated with higher cardiovascular event rates and higher mortality [HR 1.94, 95% confidence interval (CI) 1.27–2.98; HR 1.28, 95% CI 1.04–1.58], respectively. In methodologically suitable studies among dialysis patients, females, ethnic minorities, those with low education, no health insurance, low occupational level or no home ownership were significantly less likely to access cardiovascular healthcare than their more advantaged dialysis counterparts. Low education level and geographic remoteness were associated with higher cardiovascular event rates and higher mortality (HR 1.54, 95% CI 1.01–2.35; HR 1.21, 95% CI 1.08–1.37), respectively. Socially disadvantaged pre-dialysis and dialysis patients experience poorer access to specialist cardiovascular health services, and higher rates of cardiovascular events and mortality than their more advantaged counterparts.

Predictive factors associated with increased progression to dialysis in early chronic kidney disease (stage 1–3) patients

2015 ◽  
Vol 20 (5) ◽  
pp. 740-747 ◽  
Author(s):  
Nao Nohara ◽  
Hiroaki Io ◽  
Mayumi Matsumoto ◽  
Masako Furukawa ◽  
Kozue Okumura ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Predictive Factors ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Factors Associated ◽  
Stage 1

scholarly journals Incidence of chronic kidney disease in patients undergoing arthroplasty: A systematic review of the literature

2019 ◽  
Vol 11 (4) ◽  
Author(s):  
Kateir Contreras ◽  
Dayany Rodriguez ◽  
Marcela Bernal-Gutiérrez ◽  
Juan Pedro Villamizar ◽  
Romar Baquero-Galvis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Cochrane Collaboration ◽  
Review Of The Literature ◽  
Factors Associated ◽  
Acceptable Quality ◽  
The Cochrane Collaboration

Patients undergoing arthroplasty are exposed to different interventions that can lead to renal dysfunction. There is abundant evidence of the incidence and factors associated with acute kidney injury (AKI); however, the incidence and the factors associated with chronic kidney disease (CKD) are not clear. The objective of this study is to determine the incidence and associated factors in arthroplasty patients. A systematic review of the literature was carried out following the recommendations of PRISMA and the Cochrane Collaboration (PROSPERO Protocol CRD42018075929). The search was carried out in Medline, Embase, Cochrane and LILACS. No language or date limits were set. Observational studies were included: cases and controls, and cohorts. The revision of titles and abstracts and the reading of the full texts was performed in a paired manner. The quality of the evidence was evaluated with the Newcastle-Ottawa tool. The initial search found 1279 titles and abstracts. We excluded 115 duplicates, and 1153 in the reading of titles and abstracts. Three articles met the inclusion criteria and were of acceptable quality. The incidence of severe CKD after hip or knee arthroplasty was 1.2% at 1 year up to 6.5% at 9 years. The evidence of the incidence and risk factors associated with CKD in patients undergoing arthroplasty is very scarce and heterogeneous. Further primary studies are required in order to have more valid and trustable results.

Chronic kidney disease long-term outcomes

2015 ◽  
Author(s):  
Monica Beaulieu ◽  
Catherine Weber ◽  
Nadia Zalunardo ◽  
Adeera Levin
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiovascular Events ◽  
Future Research ◽  
Long Term Outcomes ◽  
Ckd Progression ◽  
Factors Associated ◽  
Specific Outcome

Chronic kidney disease (CKD) is associated with a variety of outcomes, some of which are directly and indirectly related to kidney disease, but which ultimately impact on patients’ quality of life and long-term outcomes. The events to which people with CKD are exposed ultimately determine their risk and prognosis of both progression to needing renal replacement therapy, or other morbidities and mortalities. The notion of competing risk is important. The five major outcomes of CKD are: progression of CKD, progression to ESRD (either dialysis or transplantation); death; cardiovascular events; infections; and hospitalizations. Where data is available, not only the risk of the specific outcome, but the factors which may predict those outcomes are described. Each section describes what is currently known about the frequency of the outcome, the limitations of that knowledge, the risk factors associated with outcome, and implications for care and future research. Available published literature often describes outcomes in CKD populations as if it is a homogenous group of patients. But it is well documented that outcomes in those with CKD differ depending on stage or severity, and whether they are or are not known to specialists. Where possible, each section ensures that the specific CKD cohort(s) from which the information is derived is clearly described.

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