The objective of this study is to investigate the risk factors of renal flare in patients with membranous lupus nephritis (class V lupus nephritis). Biopsy-proven pure membranous lupus nephritis patients diagnosed between January 1997 and September 2017 were studied. We assessed and compared the clinical and pathological parameters between patients who experienced renal flare and those who did not. To identify risk factors of renal flare, multivariable Cox proportional hazard regression analysis was performed. Out of the 53 patients with pure membranous lupus nephritis, 17 patients (32.1%) experienced renal flare during a median follow-up of 121.5 months (range 44.4-196.9). Patients who experienced renal flare had significantly higher proportion of tubulointerstitial inflammation (76.5% vs. 36.1%, p = 0.006) and tubular atrophy/interstitial fibrosis (70.6% vs. 27.8%, p = 0.003) at baseline. In multivariable Cox proportional hazard regression analysis, the presence of tubulointerstitial inflammation [adjusted hazard ratio (HR) 5.532, 95% confidence interval (CI) 1.722-17.776, p = 0.004] and tubular atrophy/interstitial fibrosis (adjusted HR 4.328, 95% CI 1.450-12.916, p = 0.009) at baseline was significantly associated with increased risk of renal flare. The presence of tubulointerstitial inflammation and tubular atrophy/interstitial fibrosis is associated with increased risk of renal flare in patients with membranous lupus nephritis.

中文翻译：

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V级狼疮肾炎的肾脏耀斑：肾小管间质病变患者的风险增加。

这项研究的目的是调查膜性狼疮性肾炎（V类狼疮性肾炎）患者发生肾脏耀斑的危险因素。研究了经活检证实的1997年1月至2017年9月期间诊断的纯膜性狼疮肾炎患者。我们评估并比较了经历过肾脏耀斑的患者和没有经历过肾脏耀斑的患者之间的临床和病理学参数。为了确定肾耀斑的危险因素，进行了多变量Cox比例风险回归分析。在53例纯膜性狼疮性肾炎患者中，有17例（32.1％）在中位随访121.5个月（范围为44.4-196.9）期间经历了肾脏耀斑。经历过肾脏耀斑的患者的肾小管间质炎症比例显着更高（76.5％比36.1％，p = 0。006）和肾小管萎缩/间质纤维化（70.6％对27.8％，p = 0.003）。在多变量Cox比例风险回归分析中，存在肾小管间质炎症[调整后的危险比（HR）5.532，95％的置信区间（CI）1.722-17.776，p = 0.004]和肾小管萎缩/间质纤维化（调整后的HR 4.328，95％基线时CI为1.450-12.916，p = 0.009）与肾脏耀斑风险增加显着相关。肾小管间质炎症和肾小管萎缩/间质纤维化的存在与膜性狼疮性肾炎患者发生肾耀斑的风险增加相关。在基线时95％的置信区间（CI）1.722-17.776，p = 0.004]和肾小管萎缩/间质纤维化（校正后的HR 4.328，95％CI 1.450-12.916，p = 0.009）与肾脏耀斑风险增加显着相关。肾小管间质炎症和肾小管萎缩/间质纤维化的存在与膜性狼疮性肾炎患者发生肾脏耀斑的风险增加相关。在基线时95％的置信区间（CI）1.722-17.776，p = 0.004]和肾小管萎缩/间质纤维化（校正后的HR 4.328，95％CI 1.450-12.916，p = 0.009）与肾脏耀斑风险增加显着相关。肾小管间质炎症和肾小管萎缩/间质纤维化的存在与膜性狼疮性肾炎患者发生肾脏耀斑的风险增加相关。