Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2006 Oct;3(10):e396.
doi: 10.1371/journal.pmed.0030396.

Time to renal disease and end-stage renal disease in PROFILE: a multiethnic lupus cohort

Graciela S Alarcón  1 , Gerald McGwin Jr, Michelle Petri, Rosalind Ramsey-Goldman, Barri J Fessler, Luis M Vilá, Jeffrey C Edberg, John D Reveille, Robert P Kimberly; PROFILE Study Group
Affiliations
Multicenter Study

Time to renal disease and end-stage renal disease in PROFILE: a multiethnic lupus cohort

Graciela S Alarcón et al. PLoS Med. 2006 Oct.

Abstract

Background: Renal involvement is a serious manifestation of systemic lupus erythematosus (SLE); it may portend a poor prognosis as it may lead to end-stage renal disease (ESRD). The purpose of this study was to determine the factors predicting the development of renal involvement and its progression to ESRD in a multi-ethnic SLE cohort (PROFILE).

Methods and findings: PROFILE includes SLE patients from five different United States institutions. We examined at baseline the socioeconomic-demographic, clinical, and genetic variables associated with the development of renal involvement and its progression to ESRD by univariable and multivariable Cox proportional hazards regression analyses. Analyses of onset of renal involvement included only patients with renal involvement after SLE diagnosis (n = 229). Analyses of ESRD included all patients, regardless of whether renal involvement occurred before, at, or after SLE diagnosis (34 of 438 patients). In addition, we performed a multivariable logistic regression analysis of the variables associated with the development of renal involvement at any time during the course of SLE. In the time-dependent multivariable analysis, patients developing renal involvement were more likely to have more American College of Rheumatology criteria for SLE, and to be younger, hypertensive, and of African-American or Hispanic (from Texas) ethnicity. Alternative regression models were consistent with these results. In addition to greater accrued disease damage (renal damage excluded), younger age, and Hispanic ethnicity (from Texas), homozygosity for the valine allele of FcgammaRIIIa (FCGR3A*GG) was a significant predictor of ESRD. Results from the multivariable logistic regression model that included all cases of renal involvement were consistent with those from the Cox model.

Conclusions: Fcgamma receptor genotype is a risk factor for progression of renal disease to ESRD. Since the frequency distribution of FCGR3A alleles does not vary significantly among the ethnic groups studied, the additional factors underlying the ethnic disparities in renal disease progression remain to be elucidated.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow Diagram of PROFILE Cohort Patients Included in Analyses
(A) Renal involvement (double-lined boxes). (B) ESRD (triple-lined box).
Figure 2
Figure 2. Kaplan-Meier Survival Curve for the Development of ESRD in Patients with FCGR3A*GG and FCGR3A*TT/GT
See this image and copyright information in PMC

References

    1. Ward MM, Studenski S. Clinical prognostic factors in lupus nephritis. The importance of hypertension and smoking. Arch Intern Med. 1992;152:2082–2088. - PubMed
    1. Stewart M, Petri M. Lupus nephritis outcomes: Health maintenance organizations compared to non-health maintenance organizations. J Rheumatol. 2000;27:900–902. - PubMed
    1. Kimberly RP, Lockshin MD, Sherman RL, Beary JF, Mouradian T, et al. “End-stage” lupus nephritis: Clinical course to and outcome on dialysis. Experience with 39 patients. Medicine. 1981;60:277–287. - PubMed
    1. Petri M, Perez-Gutthann S, Longenecker JC, Hochberg M. Morbidity of systemic lupus erythematosus: Role of race and socioeconomic status. Am J Med. 1991;91:345–353. - PubMed
    1. Petri M. The effect of race on incidence and clinical course in systemic lupus erythematosus: The Hopkins Lupus Cohort. J Am Med Womens Assoc. 1998;53:9–12. - PubMed

Publication types

MeSH terms