Multivariate Analysis Of Curative Effect Of Lupus Nephritis In Children

Objective:To investigate relevant factors affecting curative effect in childhood lupus nephritis.Methods:A retrospective analysis was done on 56 inpatient with first diagnosed as LN and had complete follow-up data in the first Hospital of Jilin University.All cases were divided into groups according to therapy results:complete remission group and treatment failure group.History of cases,indicators of laboratory,treatment plan and therapy results were recorded.Various factors between different groups were compared by analysis of T-test,chi-square test and Logistic regression analysis.Result:1.This study collected 56 cases of patients,there are 8male(14.29%),48female(85.71%).The youngest one is 5 years old,the oldest one is 16 years old.The average age was 11.38 ± 2.46 years.Time from kidney or urinary abnormalities to renal biopsy range from 3 days to6 months.After treatment,40 patients were complete remission,while 16 failed.2.Patients with anemia had higher treatment failure rate than those without anemia.The difference was statistically significant(p<0.05).Patients with elevated creatinine had higher treatment failure rate than those with normal creatinine(p<0.05).Whose 24 h Urinary protein≥50mg/kg had higher treatment failure ratethan those with the 24 h urinary protein<50mg/kg(p<0.05).The treatment failure rate in patients with ds-DNA negative was lower than those with ds-DNA positive(p<0.05).Incomplete response patients after induction therapy had higher treatment failurerate than complete response patients(p < 0.05).In the maintenance phase,those accepted MMF+prednisolone+ CTX therapy had lower treatment failure rate than those who were treated with MMF+prednisolone(p<0.05).Other related indicators did not havestatistical difference betweengroups(p>0.05).3.The result of multi factor analysis showed that urinary protein,the way of maintenance treatment,the reaction induced by treatment were independent risk factors.Patients whose 24 h urine protein ≥50mg/kg had higher treatment failure rate than the those with 24 h urinary protein< 50mg/kg[Or=10.433,95%CI: 1.445~75.301].Patients with complete response after induction therapy had lower treatment failure ratethan the incomplete response patients [Or= 0.251,95%CI 0.073~0.856].For maintenance treatment,the risk of treatment failure in patients withMMF+prednisolone+CTX was lower than that of the MMF+prednisolone patients[ Or= 0.122,95%CI :0.018~0.837].Conclusion:1.Anemia,elevated creatinine,massive proteinuria,ds-DNA positive were risk factors of renal failure.2.Massive proteinuria,incomplete response of induction treatment were independent risk factors for renal failure Multiple immunosuppressive agents combined therapy has positive effect in maintenance of renal outcome.