Survival analysis of lupus nephritis with neuropsychiatric systemic lupus erythematosus / 中华肾脏病杂志

ABSTRACT

Objective To investigate the survival rate and the influencing factors in lupus nephritis (LN) patients with neuropsychiatric systemic lupus erythematosus (NPSLE). Methods Clinical characteristics and biochemical markers of 78 patients including 59 variances were analyzed. Patients were followed up from the onset of NPSLE to death. Patient survival rate was estimated by Kaplan-Meier method. Cox regression model was used to analyze influencing factors. Results Sixteen (20.5%) of 78 patients died of SLE or its complications. Infection was the main cause of death (31.3%). One-, 3-, 5- and 10-year survival rates were 83.2%, 81.7%, 76.7% and 76.7%, respectively. Hypertension (RR =6.965,95% CI1.578-30.746, P= 0.010), pulmonary infection (RR=8.171,95% CI1.954-34.177, P=0.004)and acute renal failure (RR=6.978,95%CI2.063-23.609, P=0.002) were risk factors of mortality, while cyclophosphamide (CTX) impulse therapy (RR =0.130,95 % CI0.031-0.541, P=0.005) and resolution of NPSLE (RR= 0.169, 95%CI0.042-0.679,P=O.012)were protective factors. Conclusions Infection is the main cause of death in patients of LN complicated with NPSLE. Survival rate of LN patients with NPSLE in this study is lower than those of LN and NPSLE alone reported by other authors. Hypertension, pulmonary infection and acute renal failure are risk factors of mortality, while CTX impulse therapy and resolution of NPSLE reduce the mortality and improve the prognosis.