Full Papers
Absolute risk estimation of new-onset proteinuria in patients with systemic lupus erythematosus: a Danish nationwide cohort study
M. Andersen1, A. Stockmarr2, H.C. Leffers3, A. Troldborg4, A. Voss5, S. Kristensen6, B. Deleuran7, L. Dreyer8, L. Johnsen9, A. Colic10, S. Jacobsen11
- Copenhagen Research Centre for Autoimmune Connective Tissue Diseases, COPEACT Centre for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark. martin.andersen@regionh.dk
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kongens Lyngby, Denmark.
- Copenhagen Research Centre for Autoimmune Connective Tissue Diseases, COPEACT Centre for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, and The DANBIO Registry, Denmark.
- Department of Biomedicine, Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.
- Department of Rheumatology, Odense University Hospital, Odense, Denmark.
- The DANBIO Registry, Denmark, and Department of Rheumatology, Aalborg University Hospital, Centre of Rheumatic Research Aalborg (CERRA), Aalborg University, Aalborg, Denmark.
- Department of Biomedicine, Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.
- Department of Rheumatology, Aalborg University Hospital, Centre of Rheumatic Research Aalborg (CERRA), Aalborg University, Aalborg, Denmark.
- Department of Rheumatology, Centre for Rheumatology and Spine Diseases, Gentofte Hospital, Copenhagen, Denmark.
- Department of Rheumatology, Zealand University Hospital, Køge, Denmark.
- Copenhagen Research Centre for Autoimmune Connective Tissue Diseases, COPEACT Centre for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, and Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Denmark.
CER16440
2023 Vol.41, N°11
PI 2264, PF 2268
Full Papers
PMID: 37382461 [PubMed]
Received: 07/12/2022
Accepted : 17/04/2023
In Press: 28/06/2023
Published: 14/11/2023
Abstract
OBJECTIVES:
Kidney involvement and medical compliance are frequent challenges in systemic lupus erythematosus (SLE). Additional data reporting such as absolute risk estimates may strengthen risk stratification and compliance. This study provides absolute risk estimations of risk of new-onset proteinuria among SLE patients.
METHODS:
Danish SLE centres provided clinical data on first time observations of proteinuria and other clinical parameters listed in the 1997 American College of Rheumatology Classification Criteria for SLE. Time from first occurring non-renal manifestation to new-onset proteinuria or censoring defined time at risk. Multivariate Cox-regression models were used to identify risk factors for new-onset proteinuria and to calculate risk of proteinuria stratified by risk factor debut age, duration, and sex.
RESULTS:
The patient population consisted of 586 patients with SLE, mainly Caucasian (94%) women (88%), mean age at inclusion of 34.6 years (standard deviation, SD=14.4 years), observed for a mean of 14.9 years (SD=11.2 years). The cumulative prevalence of proteinuria was 40%. Discoid rash, HR =0.42 (p=0.01) and lymphopenia HR=1.77 (p=0.005) were associated with new-onset proteinuria. Male patients with lymphopenia had the highest predictive risks of proteinuria with a 1-, 5- and 10-year risk of proteinuria ranging from 9–27%, 34–75% and 51–89%, depending on the age at presentation (debut at 20, 30, 40 or 50 years). The corresponding risk profiles for women with lymphopenia were 3–9%, 8–34% and 12–58%, respectively.
CONCLUSIONS:
Large differences in absolute risk estimates for new-onset proteinuria were identified. The differences may aid risk stratification and patient compliance among high-risk individuals.
