Brief observation
Demographic differences in the development of lupus nephritis: a retrospective analysis

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Patients and methods

We studied 773 lupus patients, including 212 who had nephritis at the time of enrollment. Informed consent was obtained from all patients, and the study was approved by the institutional review board at the University of California, San Francisco. Patients were recruited between April 1997 and March 2000 from arthritis clinics at the university medical centers, private rheumatology practices in Northern California, lupus support groups and seminars, and nationwide outreach. Ethnicity (European

Results

Among the 212 patients with nephritis, 176 met nephritis criteria based on renal biopsy evidence and American College of Rheumatology criteria, 33 patients met criteria based on American College of Rheumatology criteria alone, and 3 patients met criteria based on renal biopsy evidence alone. Sixteen percent of patients (n = 121) had nephritis at the time of lupus diagnosis. Patients with nephritis were more likely to be male and less likely to be of European American ancestry (Table 1). There

Discussion

The development of renal disease is an important predictor of poor outcome in lupus. In this retrospective analysis, we found that men, non–European Americans, and patients who were younger than 33 years at lupus diagnosis were more likely to develop nephritis. Although the absolute risk of nephritis varied by sex and ethnic background, the time course for the development of nephritis was generally consistent among subgroups. The risk of nephritis was greatest during the first few years

Acknowledgements

The authors wish to thank Miriam G. Cisternas for technical assistance with this study, Edward H. Yelin for helpful suggestions about the manuscript, the staff of the Lupus Genetics Project at the University of California, San Francisco, and the patients and physicians who participated in this study.

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This work was supported by Grants AR44804 and ES09911 from the National Institutes of Health, Bethesda, Maryland, and a grant from the Northern California Chapter of the Arthritis Foundation.

These studies were carried out in part in the General Clinical Research Center, Moffitt Hospital, University of California, San Francisco, with funds provided by the National Center for Research Resources, 5 MO1 RR-00079, United States Public Health Service.

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