Creatinine clearance rate predicts prognosis of patients with systemic lupus erythematosus: a large retrospective cohort
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ORIGINAL ARTICLE
Creatinine clearance rate predicts prognosis of patients with systemic lupus erythematosus: a large retrospective cohort study Jiahuan Ge 1 & Ziyi Jin 2 & Xuebing Feng 2 & Wenyou Pan 3 & Lin Liu 4 & Min Wu 5 & Huaixia Hu 6 & Xiang Ding 7 & Hua Wei 8 & Yaohong Zou 9 & Xian Qian 10 & Meimei Wang 11 & Jian Wu 12 & Juan Tao 13 & Jun Tan 14 & Zhanyun Da 15 & Miaojia Zhang 16 & Jing Li 17 & Lingyun Sun 1,2 Received: 3 July 2020 / Revised: 6 October 2020 / Accepted: 26 October 2020 # International League of Associations for Rheumatology (ILAR) 2020
Abstract Objective To explore the association between the creatinine clearance rate (Ccr) and the prognosis of patients, and compared with estimated glomerular filtration rate (eGFR). Methods We retrospectively collected information of patients with SLE who were first hospitalized between 1999 and 2009 in Jiangsu Province, China, and followed up in 2010 and 2015. Ccr was calculated and dichotomized into normal group (Ccr ≥ 70) and decreasing group (Ccr < 70). The clinical characteristics of the two groups were compared and Cox proportional-hazards regression models were used to calculate hazard ratio (HR) and 95% confidence interval (CI). Results Among 1990 SLE patients, we observed 437 (22.0%) with decreased Ccr, including 237 cases (11.9%) with mild renal dysfunction, 136 cases (6.8%) with moderate renal dysfunction, and 64 cases (3.2%) with severe renal dysfunction. Compared to normal Ccr, decreasing Ccr had a higher risk for mortality with adjusted HR (95% CI) of 2.21 (1.59–3.06). Dose-response relationships were significantly found between increased mortality of SLE and decreased Ccr (p for trend < 0. 001), as well as eGFR. Positive associations were consistently observed in subgroups, such as systemic lupus disease activity index (SLEDAI) ≥ 15, without comorbidities and abnormal laboratory indexes. Decreasing Ccr was positively associated with mortality from infection and renal failure with HR (95% CI) of 1.80 (1.02–3.19) and 6.84 (3.05–15.36). Jiahuan Ge and Ziyi Jin contributed equally as first authors. Ziyi Jin and Lingyun Sun contributed equally as senior authors. * Ziyi Jin [email protected]
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Department of Rheumatology, Northern Jiangsu People’s Hospital, Yangzhou, China
* Lingyun Sun [email protected]
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Department of Rheumatology, Wuxi People’s Hospital, Wuxi, China
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Department of Rheumatology, Jiangsu Province Hospital of TCM, Nanjing, China
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Department of Rheumatology, Southeast University Zhongda Hospital, Nanjing, China
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Department of Rheumatology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Department of Rheumatology, Wuxi TCM Hospital, Wuxi, China
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Department of Rheumatology, Zhenjiang First People’s Hospital, Zhenjiang, China
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Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, China
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Department of Rheumatology, Jiangsu Province Hospital, Nanjing, China
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Department of Rheumatology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
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