Lupus nephritis is associated with increased risk of end-stage renal disease (ESRD) and all-cause mortality. We evaluated the clinical features and outcomes of patients with early and delayed lupus nephritis. The medical records of 171 patients who met the 1997 revised classification criteria for systemic lupus erythematosus (SLE) with pathologic confirmation of lupus nephritis were reviewed. Early lupus nephritis was defined when lupus nephritis was histopathologically confirmed as the first clinical manifestation of SLE, whereas delayed lupus nephritis was defined as lupus nephritis that was identified after the diagnosis of SLE. Clinical and laboratory data, as well as kidney histopathology and medication usage were investigated. Kaplan-Meier and Cox-proportional hazard analysis was performed to compare the outcomes of early and delayed lupus nephritis and evaluate factors associated with ESRD and all-cause mortality. Patients with early lupus nephritis had higher disease activity (median non-renal SLE disease activity index-2000, 6.0 vs. 4.0; p < 0.001) and more frequent skin rash, oral ulcer and serositis; however, the proportion of patients with higher renal chronicity index was greater in the delayed lupus nephritis group (p = 0.007). Nevertheless, no difference was found regarding ESRD and all-cause mortality between the groups. In Cox-proportional hazard analysis, C-reactive protein level, creatinine level and chronicity index were factors associated with ESRD, while age and haemoglobin level were associated with all-cause mortality. In conclusion, clinical outcomes of early and delayed lupus nephritis are not significantly different. Rigorous adherence to current treatment recommendations is essential for the treatment of lupus nephritis.

中文翻译：

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早期和迟发性狼疮性肾炎患者临床特征和结局的比较。

狼疮性肾炎与终末期肾病 (ESRD) 和全因死亡率的风险增加有关。我们评估了早期和迟发性狼疮性肾炎患者的临床特征和结局。对符合 1997 年修订的系统性红斑狼疮 (SLE) 分类标准并经病理证实为狼疮性肾炎的 171 名患者的病历进行了审查。早期狼疮性肾炎定义为狼疮性肾炎组织病理学证实为 SLE 的首发临床表现，而迟发性狼疮性肾炎定义为 SLE 诊断后发现的狼疮性肾炎。研究了临床和实验室数据，以及肾脏组织病理学和药物使用情况。进行 Kaplan-Meier 和 Cox 比例风险分析以比较早期和延迟狼疮肾炎的结果，并评估与 ESRD 和全因死亡率相关的因素。早期狼疮性肾炎患者的疾病活动度较高（非肾性 SLE 疾病活动度指数中位数 - 2000，6.0 对 4.0；p < 0.001）和更频繁的皮疹、口腔溃疡和浆膜炎；然而，延迟性狼疮性肾炎组中肾慢性指数较高的患者比例更大（p = 0.007）。然而，两组之间的 ESRD 和全因死亡率没有差异。在 Cox 比例风险分析中，C 反应蛋白水平、肌酐水平和慢性病指数是与 ESRD 相关的因素，而年龄和血红蛋白水平与全因死亡率相关。综上所述，早期和迟发性狼疮性肾炎的临床结果没有显着差异。严格遵守当前的治疗建议对于狼疮性肾炎的治疗至关重要。