IMPACT OF RACE ON LUPUS NEPHRITIS REMISSION

 

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IMPACT OF RACE ON LUPUS NEPHRITIS REMISSION

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Harini
Manivannan
Harini Manivannan harini007@e.ntu.edu.sg Nanyang Technological University Lee Kong Chian School of Medicine Singapore Singapore *
Hanyang Du HDU004@e.ntu.edu.sg Nanyang Technological University Lee Kong Chian School of Medicine Singapore Singapore -
Cynthia Lim Ciwei cynthia.lim.c.w@singhealth.com.sg Singapore General Hospital Department of Renal Medicine Singapore Singapore -
Julia G Andres julia.andres@mohh.com.sg Singapore General Hospital Department of Renal Medicine Singapore Singapore -
Jason Choo Chon Jun jason.choo@singhealth.com.sg Singapore General Hospital Department of Renal Medicine Singapore Singapore -
Irene Mok Yanjia irene.mok.y.j@singhealth.com.sg Singapore General Hospital Department of Renal Medicine Singapore Singapore -
Tung Lin Lee lee.tung.lin@singhealth.com.sg Singapore General Hospital Department of Renal Medicine Singapore Singapore -
Hui Zhuan Tan tan.hui.zhuan@singhealth.com.sg Singapore General Medicine Department of Renal Medicine Singapore Singapore -
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Lupus nephritis (LN) affects 60% of individuals with Systemic Lupus Erythematosus (SLE) and poses a significant risk of progression to kidney failure. Racial disparities in LN prognosis may be due to genetic, environmental, and socio-economic factors that drive differential treatment response. However, data from Southeast Asia is scarce. This study aimed to assess the relationship between the race and LN remission in Singapore.

We performed a single-centre, retrospective cohort study with convenience sampling of all adults diagnosed with biopsy-confirmed LN between 2018 and 2020. Data was retrieved from electronic medical records every 6 months for three years from diagnosis. The outcome was remission (improved proteinuria <0.5 g/g and stable or improved kidney function). To account for variability across patients and repeated measures over time, we used mixed effects logistic regression to examine the association of race with remission included random intercepts for patientsand fixed effects for follow-up duration.

We included 73 adults (Chinese 77.1%, Malay 11.6%, Indian 3.3%) with median eGFR 107.0 (interquartile range [IQR]: 74.4, 122.7) ml/min1.73 m2 and urine protein-to-creatinine ratio 3.28 (IQR: 1.51, 7.47) g/g. Remission occurred in 215 of the 301 visits (71.4%): 159 of 232 visits (68.5%) for Chinese, 26 of 35 visits (74.3%) for Malays and 7 of 10 visits (70%) for Indians. There was no difference in remission for Malays (adjusted OR 1.55, 95% CI: 0.32–7.4, p=0.59) and Indians (adjusted OR 0.90, 95% CI: 0.06–12.18, p=0.94) compared to Chinese.


In this multi-racial Southeast Asian cohort, there was nosignificant difference in LN remission at 6-monthly follow-up visits for Malays and Indians, compared to Chinese.

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