The Risk Factors for Lupus Nephritis

Abstract

Abstract Background Lupus nephritis (LN) is the most common cause of kidney injury in systemic lupus erythematosus and a major risk factor for morbidity and mortality, genetic and environmental factors likely contribute to LN, however, the pathogenesis of LN is still unclear. The purpose of this study is to analysis the risk factors of LN and predicts clinical prognosis. Methods A total of 736 systemic lupus erythematosus (SLE) were included, according to urinary protein quantification have been divided into LN group and without LN group, collected their clinical characteristics and analyzed. Results The levels of WBC(5.24 ± 0.21vs4.47 ± 0.13)x109/L,NEU(3.72 ± 0.18vs3.00 ± 0.11)x109/L,NLR(4.50 ± 0.30vs3.66 ± 0.25),FAR(0.12 ± 0.01vs0.08 ± 0.01),BAR(0.35 ± 0.02vs0.16 ± 0.02),CAR(0.53 ± 0.07vs0.33 ± 0.03),NAR(0.14 ± 0.01vs0.09 ± 0.01),DAR(0.13 ± 0.01vs0.06 ± 0.01),ESR(61.21 ± 2.23vs46.28 ± 1.55)mm/h,ALT(58.96 ± 7.08vs40.76 ± 3.50)U/L,UA(375.64 ± 8.86vs276.93 ± 4.60)umol/L,Cr(91.10 ± 6.82vs52.47 ± 1.56)umol/L,BUN(8.83 ± 0.51vs5.48 ± 0.62)mmol/L,TC(4.38 ± 0.10vs3.65 ± 0.04)mmol/L,TG(2.13 ± 0.09vs1.56 ± 0.04)mmol/L,LDL(2.33 ± 0.06vs1.91 ± 0.03)mmol/L,Fib(3.18 ± 0.07vs2.90 ± 0.05)g/L,FDP(8.50 ± 0.61vs5.41 ± 0.34)ug/mL,D-D(3.28 ± 0.26vs2.08 ± 0.15)ug/mL, LDH(292.87 ± 12.84vs242.24 ± 7.51)U/L,α-HBDH(244.75 ± 8.66vs203.90 ± 5.69)U/L and Cys C (1.94 ± 0.07vs1.25 ± 0.02)mg/L were increased significantly in LN group (p < 0.05);the levels of RBC(3.32 ± 0.04vs3.74 ± 0.03)x1012/L,HGB(95.30 ± 1.23vs108.31 ± 0.96)g/L,ALB(28.46 ± 0.39vs35.85 ± 0.24)g/L,C3(0.48 ± 0.02vs0.68 ± 0.01)g/L and C4(0.09 ± 0.00vs0.12 ± 0.00)g/L were decreased obviously (p < 0.05),the positive rate of anti-double-stranded (ds) DNA (54.54%vs36.23%) was higher in LN group (p < 0.05). FAR(r = 0.151), CAR(r = 0.166), ALB(r = 0.290), Fib(r = 0.366) and TC(r = 0.194) were positively correlated with complement C3 (p < 0.05); BAR(r=-0.162), LDH(r=-0.129), α-HBDH(r=-0.152) and IgG(r=-0.144)were negatively correlated with complement C3 (p < 0.05); NAR(r = 0.045), DAR(r=-0.08), TG(r=-0.048), LDL-c(r = 0.113), D-D(r=-0.06) and FDP(r=-0.068) were no correlated with complement C3 (p > 0.05); CAR (OR 0.751,95%CI 0.579–0.975; p = 0.032), DAR (OR 1.063, 95%CI 1.011–1.118; p = 0.025), ALB (OR 0.807,95%CI 0.732–0.891; p = 0.001), TC (OR 1.517,95%CI 1.109–2.076; p = 0.009) and D-D (OR 0.592, 95%CI 0.369–0.950; p = 0.03) were LN risk factors. Conclusion The levels of WBC, NEU, NLR, FAR, BAR, CAR, NAR, DAR, ESR, ALT, UA, Cr, BUN, TC, TG, LDL, Fib, FDP, D-D, LDH,α-HBDH and Cys C were increased in LN patients, and the levels of RBC, HGB, ALB, C3 and C4 were decreased. CAR, DAR, ALB, TC and D-D were the risk factors for LN patients.