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Incidence and disease severity of anti-neutrophil cytoplasmic antibody-associated nephritis are higher than in lupus nephritis in Sweden.
Lunds University, Addenbrooke's Hospital Cambridge UK.
Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Region Östergötland, Heart and Medicine Center, Department of Nephrology.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
Lund University, Malmö .
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2015 (English)In: Nephrology, Dialysis and Transplantation, ISSN 0931-0509, E-ISSN 1460-2385, Vol. 30, i23-i30 p.Article in journal (Refereed) Published
Abstract [en]

Objectives :The objectives of this study were to compare incidence rates, renal and patient survival between lupus nephritis (LN) and anti-neutrophil cytoplasmic antibody-associated nephritis (AAN) during a 12-year period in two geographically defined populations in Sweden.

METHODS: In the health care districts surrounding the Skåne University Hospital in Lund [mean population ≥18 years (1997-2008), 188 400] and the University Hospital in Linköping [mean population ≥18 years (1997-2008), 328 900] all patients with biopsy-proven LN and AAN during the period 1997-2008 were included in the study if they (i) were residing within the study areas at the time of onset of nephritis, (ii) had a clinical diagnosis of either SLE or ANCA-associated vasculitis (AAV) and (iii) experienced a first flare of biopsy-proven nephritis during the study period.

RESULTS: Eighty-two patients (Lund 44 + Linköping 38) with biopsy-proven AAN were identified and 27 patients with LN (Lund 13 + Linköping 14). The annual incidence rate per million inhabitants aged ≥18 years in both study areas was estimated to be 13.2 (95% CI 10.4-16.1) for AAN and 4.3 (95% CI 2.7-6.0) for LN, P < 0.001. The patients were followed until January 2013. During the follow-up time 38 patients died (AAN 36, LN 2; P = 0.001), and 20 patients went into end-stage renal disease (AAN 19 and LN 1), P = 0.020.

CONCLUSIONS: In Sweden, AAN was three times more common than LN, and the outcome was considerably worse. SLE is often diagnosed before the onset of nephritis leading to earlier treatment, while AAN is still often diagnosed at a later stage.

Place, publisher, year, edition, pages
Oxford University Press, 2015. Vol. 30, i23-i30 p.
National Category
Basic Medicine Rheumatology and Autoimmunity
URN: urn:nbn:se:liu:diva-113101DOI: 10.1093/ndt/gfu396ISI: 000353500300005PubMedID: 25540097OAI: diva2:777887
Available from: 2015-01-09 Created: 2015-01-09 Last updated: 2016-03-22

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Weiner, MariaSjöwall, ChristopherEriksson, PerSegelmark, Mårten
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Faculty of Medicine and Health SciencesDivision of Drug ResearchDepartment of NephrologyDivision of Neuro and Inflammation ScienceDepartment of RheumatologyDepartment of NephrologyFaculty of Health Sciences
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Nephrology, Dialysis and Transplantation
Basic MedicineRheumatology and Autoimmunity

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