Predictors of mortality in children with lupus nephritis
Journal Title: Paediatrica Indonesiana - Year 2014, Vol 54, Issue 6
Abstract
Background Renal involvement during the clinical course ofsystemic lupus erythematosus (SLE) is generally considered to bethe most important factor influencing disease prognosis in termsof morbidity and mortality. Various factors have been reported toinfluence the prognosis of lupus nephritis (LN).Objective To analyze clinical signs and laboratory parameters thatmight serve as predictors associated with mortality in pediatricLN.Methods Retrospectively, medical records of children with LNat Soetomo Hospital from 1998 to 2011 were studied. Diagnosisof SLE was based on Revised American Rheumatism Associationcritera, while patients with clinical manifestations of hypertension,abnormal urinalysis, and serum creatinin > 1 mg/dL wereconsidered as lupus nephritis. Cox proportional hazard modelingwas used to assess for associations of clinical signs and laboratoryparameters with mortality. Kaplan-Meier survival analysis wasused to assess the cumulative survival from the time of diagnosisto the outcome.Results There were 57 children with LN of whom 43 (75%) weregirls. The female-to-male ratio was 3:1. Subjects’ mean age was 10.6(SD 6.87) years. The mean time of observation was 51 (SD 74.54)months and 23 (40%) children died. Age, gender, hypertension,hematuria, proteinuria, and anemia were not significant aspredictors for mortality. However, hypertensive crisis (HR=2.79;95%CI 1.16 to 6.75; P=0.02) and initial glomerular filtration rate(GFR) of <75 mL/min/1.73m2 (HR=3.01; 95%CI 1.23 to 7.34;P=0.01) were significant predictors of mortality in children with LN.The mean survival time of LN with hypertensive crisis and initialGFR <75 mL/min/1.73m2 was 36.9 (SD 12.17) months.Conclusion Hypertensive crisis and GFR <75 mL/min/1.73m2 aresignificant predictors of mortality in children with LN.
Authors and Affiliations
Lukman Oktadianto, Risky Prasetyo, Ninik Soemyarso, Mohammad Noer
Keywords
Related Articles
- EP ID EP458757
- DOI 10.14238/pi54.6.2014.338-43
- Views 74
- Downloads 0
The pediatric index of mortality 3 score to predict mortality in a pediatric intensive care unit in Palembang, South Sumatera, Indonesia
Background For critically ill patients in the pediatric intensive care unit (PICU), a scoring system is helpful for assessing the severity of morbidity and predicting the risk of mortality. The Pediatric Index of Mortali...
Efficacy of sputum induction from lower respiratory tract in children
Background Although sputum is a good specimen for variousexaminations, such as cytology and microbiological culture,sputum induction (SI) is not a routine procedure in children.Objective To identify the efficacy of SI to...
Effect of oral administration of probiotics on intestinal colonization with drug-resistant bacteria in preterm infants
Background Oral administration of probiotics in newborn preterm infants has been shown to be helpful, especially ın reducıng the incidence of necrotizing enterocolitis and overall mortality rates.Objective To evaluate th...
Left ventricular mass in male adolescent athletes and non-athletes
Background Systematic exercise leads to increased left ventricular mass, which may be misleading in a differential diagnosis of heart disease in athletes (physiologic hypertrophy versus pathologic hypertrophy). T he caus...
Visfatin levels in non-obese, obese, and insulin resistant adolescents
Background Adipose tissue is not merely a site for energy storage, but is also the largest endocrine organ, secreting various adipocytokines. Plasma visfatin, an adipocytokine predominantly secreted from visceral adipose...