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we aim to evaluate the clinicopathological characteristics and prognosis of patients with lupus nephritis (LN) who also have acute kidney injury (AKI), and to analyze the risk factors influencing the prognosis of LN patients.
This retrospective cohort study enrolled patients diagnosed with LN in the Department of Nephrology at Ningxia Medical University General Hospital from September 2008 to March 2019. Patients were divided into two groups based on their baseline renal function: the AKI group and normal kidney function group. Clinicopathological data were compared between the two groups, and further exploration was conducted to identify the risk factors influencing the prognosis of LN patients.
A total of 276 LN patients were included, including 119 (43.12%) experienced AKI. Compared to the normal renal function group, the AKI group exhibited a higher proportion of male, blood urea nitrogen, creatinine, uric acid, proteinuria, and the lupus activity index, lower levels of, eGFR, total protein, albumin. Multivariate Cox regression model revealed that the AKI group faced a 4.381-fold higher risk of reaching endpoint events compared to those with normal renal function (HR 4.381, P=0.005).Cardiovascular involvement, neuropsychiatric involvement, increased lupus activity index, baseline 24-hour urine protein quantification exceeding 2 g, and reduced eGFR levels emerged as independent risk factors for endpoint events in LN patients (P<0.05). Kaplan-Meier survival analysis demonstrated that LN patients with comorbid AKI had a less favorable prognosis (P<0.05).
In cases of LN combined with AKI, patients often exhibit histological subtype IV and frequently present with involvement of other organ systems. This not only results in severe kidney damage but also leads to substantial harm to extrarenal organs, ultimately contributing to a poorer long-term prognosis.