Pure Membranous Lupus Nephritis: Description of a Cohort of 150 Patients and Review of the Literature

Lucía  Silva-Fernández; Teresa Otón; Anca Askanase; Patricia Carreira; Francisco Javier Lopez-Longo; Alejandro Olive; Inigo Rua-Figuero; Esther Ruiz-Lucea; Mariano Andres; Enrique Calvo; Francisco Toyos; Juan Jose Alegre-Sancho; Eva Tomero; Carlos Montilla; Antonio Zea; Esther Uriarte; Jaime Calvo-Alen; Carlos Marras; Victor M. Martinez-Taboada; Maria Angeles Belmonte-Lopez; Jose Rosas; Enrique Raya; Gema Bonilla; Mercedes Freire; Jose Maria Pego-Reigosa; Isabel Millan; Adwoa Parker

doi:10.1016/j.reuma.2017.04.005

Pure Membranous Lupus Nephritis: Description of a Cohort of 150 Patients and Review of the Literature

Lucía Silva-Fernández, Teresa Otón, Anca Askanase, Patricia Carreira, Francisco Javier Lopez-Longo, Alejandro Olive, Inigo Rua-Figuero, Esther Ruiz-Lucea, Mariano Andres, Enrique Calvo, Francisco Toyos, Juan Jose Alegre-Sancho, Eva Tomero, Carlos Montilla, Antonio Zea, Esther Uriarte, Jaime Calvo-Alen, Carlos Marras, Victor M. Martinez-Taboada, Maria Angeles Belmonte-LopezJose Rosas, Enrique Raya, Gema Bonilla, Mercedes Freire, Jose Maria Pego-Reigosa, Isabel Millan, Adwoa Parker

Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

Objectives
The course and long-term outcome of pure membranous lupus nephritis (MLN) are little understood. The aims of this study are to evaluate the clinical features, course, outcome and prognostic indicators in pure MLN and to determine the impact of ethnicity and the type of health insurance on the course and prognosis of pure MLN.

Methods
We conducted a retrospective review of medical records of 150 patients with pure MLN from Spain and the USA.

Results
Mean age was 34.2±12.5 and 80% were women. Sixty-eight percent of patients had nephrotic syndrome at diagnosis. The average serum creatinine was 0.98±0.78mg/dl. Six percent of patients died and 5.3% developed end-stage renal disease (ESRD). ESRD was predicted by male sex, hypertension, dyslipidemia, high basal 24h-proteinuria, high basal serum creatinine and a low basal creatinine clearance. Age, cardiac insufficiency, peripheral artheriopathy, hemodialysis and not having received mycophenolate mofetil or antimalarials for MLN predicted death.

Conclusions
Pure MLN frequently presents with nephrotic syndrome, high proteinuria and normal serum creatinine. Its prognosis is favourable in maintaining renal function although proteinuria usually persists over time. Baseline cardiovascular disease and not having a health insurance are related with poor prognosis.

Original language	English
Journal	Reumatología clínica
Early online date	18 May 2017
DOIs	https://doi.org/10.1016/j.reuma.2017.04.005
Publication status	E-pub ahead of print - 18 May 2017

Bibliographical note

© 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy.

Keywords

Systemic lupus erythematosus
Retrospective review
Membranous glomerulonephritis

Access to Document

10.1016/j.reuma.2017.04.005

Silva_Fernandez_2017_Pure_Membranous_Lupus_Nephritis_Description_of_a_Cohort_of_150_patients
© 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy.
Accepted author manuscript, 272 KBLicence: CC BY-NC-ND

Cite this

Silva-Fernández, L., Otón, T., Askanase, A., Carreira, P., Lopez-Longo, F. J., Olive, A., Rua-Figuero, I., Ruiz-Lucea, E., Andres, M., Calvo, E., Toyos, F., Alegre-Sancho, J. J., Tomero, E., Montilla, C., Zea, A., Uriarte, E., Calvo-Alen, J., Marras, C., Martinez-Taboada, V. M., ... Parker, A. (2017). Pure Membranous Lupus Nephritis: Description of a Cohort of 150 Patients and Review of the Literature. Reumatología clínica. Advance online publication. https://doi.org/10.1016/j.reuma.2017.04.005

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title = "Pure Membranous Lupus Nephritis: Description of a Cohort of 150 Patients and Review of the Literature",

abstract = "ObjectivesThe course and long-term outcome of pure membranous lupus nephritis (MLN) are little understood. The aims of this study are to evaluate the clinical features, course, outcome and prognostic indicators in pure MLN and to determine the impact of ethnicity and the type of health insurance on the course and prognosis of pure MLN.MethodsWe conducted a retrospective review of medical records of 150 patients with pure MLN from Spain and the USA.ResultsMean age was 34.2±12.5 and 80% were women. Sixty-eight percent of patients had nephrotic syndrome at diagnosis. The average serum creatinine was 0.98±0.78mg/dl. Six percent of patients died and 5.3% developed end-stage renal disease (ESRD). ESRD was predicted by male sex, hypertension, dyslipidemia, high basal 24h-proteinuria, high basal serum creatinine and a low basal creatinine clearance. Age, cardiac insufficiency, peripheral artheriopathy, hemodialysis and not having received mycophenolate mofetil or antimalarials for MLN predicted death.ConclusionsPure MLN frequently presents with nephrotic syndrome, high proteinuria and normal serum creatinine. Its prognosis is favourable in maintaining renal function although proteinuria usually persists over time. Baseline cardiovascular disease and not having a health insurance are related with poor prognosis.",

keywords = "Systemic lupus erythematosus, Retrospective review, Membranous glomerulonephritis",

author = "Luc{\'i}a Silva-Fern{\'a}ndez and Teresa Ot{\'o}n and Anca Askanase and Patricia Carreira and Lopez-Longo, {Francisco Javier} and Alejandro Olive and Inigo Rua-Figuero and Esther Ruiz-Lucea and Mariano Andres and Enrique Calvo and Francisco Toyos and Alegre-Sancho, {Juan Jose} and Eva Tomero and Carlos Montilla and Antonio Zea and Esther Uriarte and Jaime Calvo-Alen and Carlos Marras and Martinez-Taboada, {Victor M.} and Belmonte-Lopez, {Maria Angeles} and Jose Rosas and Enrique Raya and Gema Bonilla and Mercedes Freire and Pego-Reigosa, {Jose Maria} and Isabel Millan and Adwoa Parker",

note = "{\textcopyright} 2017 Elsevier Espa{\~n}a, S.L.U. and Sociedad Espa{\~n}ola de Reumatolog{\'i}a y Colegio Mexicano de Reumatolog{\'i}a. All rights reserved. This is an author-produced version of the published paper. Uploaded in accordance with the publisher{\textquoteright}s self-archiving policy. ",

year = "2017",

month = may,

day = "18",

doi = "10.1016/j.reuma.2017.04.005",

language = "English",

journal = "Reumatolog{\'i}a cl{\'i}nica",

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Silva-Fernández, L, Otón, T, Askanase, A, Carreira, P, Lopez-Longo, FJ, Olive, A, Rua-Figuero, I, Ruiz-Lucea, E, Andres, M, Calvo, E, Toyos, F, Alegre-Sancho, JJ, Tomero, E, Montilla, C, Zea, A, Uriarte, E, Calvo-Alen, J, Marras, C, Martinez-Taboada, VM, Belmonte-Lopez, MA, Rosas, J, Raya, E, Bonilla, G, Freire, M, Pego-Reigosa, JM, Millan, I & Parker, A 2017, 'Pure Membranous Lupus Nephritis: Description of a Cohort of 150 Patients and Review of the Literature', Reumatología clínica. https://doi.org/10.1016/j.reuma.2017.04.005

TY - JOUR

T1 - Pure Membranous Lupus Nephritis: Description of a Cohort of 150 Patients and Review of the Literature

AU - Silva-Fernández, Lucía

AU - Otón, Teresa

AU - Askanase, Anca

AU - Carreira, Patricia

AU - Lopez-Longo, Francisco Javier

AU - Olive, Alejandro

AU - Rua-Figuero, Inigo

AU - Ruiz-Lucea, Esther

AU - Andres, Mariano

AU - Calvo, Enrique

AU - Toyos, Francisco

AU - Alegre-Sancho, Juan Jose

AU - Tomero, Eva

AU - Montilla, Carlos

AU - Zea, Antonio

AU - Uriarte, Esther

AU - Calvo-Alen, Jaime

AU - Marras, Carlos

AU - Martinez-Taboada, Victor M.

AU - Belmonte-Lopez, Maria Angeles

AU - Rosas, Jose

AU - Raya, Enrique

AU - Bonilla, Gema

AU - Freire, Mercedes

AU - Pego-Reigosa, Jose Maria

AU - Millan, Isabel

AU - Parker, Adwoa

N1 - © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy.

PY - 2017/5/18

Y1 - 2017/5/18

N2 - ObjectivesThe course and long-term outcome of pure membranous lupus nephritis (MLN) are little understood. The aims of this study are to evaluate the clinical features, course, outcome and prognostic indicators in pure MLN and to determine the impact of ethnicity and the type of health insurance on the course and prognosis of pure MLN.MethodsWe conducted a retrospective review of medical records of 150 patients with pure MLN from Spain and the USA.ResultsMean age was 34.2±12.5 and 80% were women. Sixty-eight percent of patients had nephrotic syndrome at diagnosis. The average serum creatinine was 0.98±0.78mg/dl. Six percent of patients died and 5.3% developed end-stage renal disease (ESRD). ESRD was predicted by male sex, hypertension, dyslipidemia, high basal 24h-proteinuria, high basal serum creatinine and a low basal creatinine clearance. Age, cardiac insufficiency, peripheral artheriopathy, hemodialysis and not having received mycophenolate mofetil or antimalarials for MLN predicted death.ConclusionsPure MLN frequently presents with nephrotic syndrome, high proteinuria and normal serum creatinine. Its prognosis is favourable in maintaining renal function although proteinuria usually persists over time. Baseline cardiovascular disease and not having a health insurance are related with poor prognosis.

AB - ObjectivesThe course and long-term outcome of pure membranous lupus nephritis (MLN) are little understood. The aims of this study are to evaluate the clinical features, course, outcome and prognostic indicators in pure MLN and to determine the impact of ethnicity and the type of health insurance on the course and prognosis of pure MLN.MethodsWe conducted a retrospective review of medical records of 150 patients with pure MLN from Spain and the USA.ResultsMean age was 34.2±12.5 and 80% were women. Sixty-eight percent of patients had nephrotic syndrome at diagnosis. The average serum creatinine was 0.98±0.78mg/dl. Six percent of patients died and 5.3% developed end-stage renal disease (ESRD). ESRD was predicted by male sex, hypertension, dyslipidemia, high basal 24h-proteinuria, high basal serum creatinine and a low basal creatinine clearance. Age, cardiac insufficiency, peripheral artheriopathy, hemodialysis and not having received mycophenolate mofetil or antimalarials for MLN predicted death.ConclusionsPure MLN frequently presents with nephrotic syndrome, high proteinuria and normal serum creatinine. Its prognosis is favourable in maintaining renal function although proteinuria usually persists over time. Baseline cardiovascular disease and not having a health insurance are related with poor prognosis.

KW - Systemic lupus erythematosus

KW - Retrospective review

KW - Membranous glomerulonephritis

U2 - 10.1016/j.reuma.2017.04.005

DO - 10.1016/j.reuma.2017.04.005

M3 - Article

SN - 2173-5743

JO - Reumatología clínica

JF - Reumatología clínica

ER -