Impact of race on comorbidity burden and clinical outcomes among Southeast Asians with lupus nephritis: a single-center retrospective study.
Source: PubMed, NCBI / U.S. National Library of Medicine
Data on lupus nephritis (LN) prognosis in the diverse Asian races outside of East Asia is scarce. We aimed to evaluate the cardiometabolic comorbidity burden and outcomes of LN in a multi-racial Southeast Asian population. Single-center, retrospective cohort study of 340 patients with biopsy-proven LN between 2011 and 2023. The outcome was kidney failure and/or death. Among Chinese (252 patients), Malay (57 patients), Indian (11 patients) and other races (20 patients), the median age was 42.3 years (interquartile range 31.4-52.8). Chinese were older at diagnosis than other races (p = 0.002). Malays were less likely to be older than Chinese (odds ratio [OR] 0.33, 95% confidence interval [CI] 0.18-0.61). Diabetes mellitus was more frequent in Malays (OR 3.05, 95% CI 1.04-8.97) and Indians (OR 5.65, 95% CI 1.06-30.06) than Chinese. Compared to Chinese and Malays, other races were less likely to have hypertension and renin-angiotensin system blocker (OR 0.27, 95% CI 0.08-0.96 and OR 0.20, 95% CI 0.06-0.69, respectively). There were no differences in hyperlipidemia, ischemic heart disease, kidney histology, and induction immunosuppressant type. During the median follow-up of 50 (38, 74) months, 49 patients (14.4%) developed kidney failure and/or died. Adjusting for cardiometabolic risk factors (age > 40 years, male sex, eGFR < 60 ml/min/1.73 m, diabetes mellitus, hypertension, hyperlipidemia and ischemic heart
Abstract
Data on lupus nephritis (LN) prognosis in the diverse Asian races outside of East Asia is scarce. We aimed to evaluate the cardiometabolic comorbidity burden and outcomes of LN in a multi-racial Southeast Asian population. Single-center, retrospective cohort study of 340 patients with biopsy-proven LN between 2011 and 2023. The outcome was kidney failure and/or death. Among Chinese (252 patients), Malay (57 patients), Indian (11 patients) and other races (20 patients), the median age was 42.3 years (interquartile range 31.4-52.8). Chinese were older at diagnosis than other races (p = 0.002). Malays were less likely to be older than Chinese (odds ratio [OR] 0.33, 95% confidence interval [CI] 0.18-0.61). Diabetes mellitus was more frequent in Malays (OR 3.05, 95% CI 1.04-8.97) and Indians (OR 5.65, 95% CI 1.06-30.06) than Chinese. Compared to Chinese and Malays, other races were less likely to have hypertension and renin-angiotensin system blocker (OR 0.27, 95% CI 0.08-0.96 and OR 0.20, 95% CI 0.06-0.69, respectively). There were no differences in hyperlipidemia, ischemic heart disease, kidney histology, and induction immunosuppressant type. During the median follow-up of 50 (38, 74) months, 49 patients (14.4%) developed kidney failure and/or died. Adjusting for cardiometabolic risk factors (age > 40 years, male sex, eGFR < 60 ml/min/1.73 m, diabetes mellitus, hypertension, hyperlipidemia and ischemic heart disease), race was not significantly associated with patient and kidney survival, but reduced kidney function (adjusted OR 5.77, 95% CI 2.77-12.01) was. Future studies should include under represented ethnic groups to better understand race-specific cardiometabolic risk profiles and their effects on LN outcomes.