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US patients of Hispanic and African ancestry develop lupus nephritis early in the disease course: data from LUMINA, a multiethnic US cohort (LUMINA LXXIV)
  1. Paula I Burgos1,2,
  2. Gerald McGwin Jr3,4,
  3. Guillermo J Pons-Estel1,
  4. John D Reveille5,
  5. Graciela S Alarcón1,
  6. Luis M Vilá6
  1. 1Department of Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
  2. 2Department of Clinical Immunology and Rheumatology, School of Medicine, Pontificia Universidad Católica de Chile, Chile
  3. 3Department of Sugery, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
  4. 4Department of Epidemiology, School of Public Health, The University of Alabama at Birmingham, Birmingham, Alabama, USA
  5. 5Department of Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA
  6. 6Department of Medicine, The University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, Spain
  1. Correspondence to Graciela S Alarcón, Department of Medicine, Schools of Medicine and Public Health, The University of Alabama at Birmingham, 830 Faculty Office Tower, 510 20th Street South, Birmingham, AL 35294-3408, USA; galarcon{at}

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Lupus nephritis (LN) is a major cause of morbidity and mortality in systemic lupus erythematosus (SLE).1 As previously described, LN occurs more frequently in Hispanic and African-American people in the multiethnic US LUMINA (Lupus in Minorities: Nature vs Nurture) cohort.2 With more patients (one-third) and years of observation (2949.3 patient-years from enrolment or baseline), we have now examined whether LN occurs earlier in the disease course in these patients relative to Caucasians. Four hundred and forty-nine patients (American College of Rheumatology (ACR) criteria, age ≥16 years, disease duration ≤5 years, predominantly women) were studied. Time-to-LN (ACR criterion (persistent proteinuria >0.5 g/day or ≥3 if quantitation not performed or cellular casts)) from baseline (incident cases) was examined by multivariable Cox proportional hazards regression adjusting for pertinent …

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  • Funding Supported by grants from the National Institute of Arthritis and Musculoskeletal and Skin Disease P01 AR49084, General Clinical Research Centers M01-RR02558 (UTH) and M01-RR00032 (UAB) and from the National Center for Research Resources (NCRR/HIH) RCMI Clinical Research Infrastructure Initiative (RCRII) 1P20RR11126 (UPR). The work of PIB was also supported by Programa de Postgrado Becas Chile.

  • Competing interests None.

  • Ethics approval The Institutional Review Board of the study centres approved the study. Written informed consent was obtained from each subject according to the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.