BPLNBlack Practitioners and Learners Network (UK)
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Four (13,23,24,27) of the six studies reported that renal failure was the main cause of death in patients with BPLN, and that the following parameters were risk factors for renal failure in patients with BPLN: class IV nephritis; male sex; hypertension; nephrotic syndrome; thrombocytopenia; hypocomplementemia; abnormal urinalysis; elevated anti-DNA antibody titers; and decreased creatinine clearance rate (Table 3).
The present meta-analysis was designed with the aim of improving our understanding of the epidemiology of BPLN. Although clinical findings such as proteinuria, hematuria, and elevated serum creatinine are often used for the diagnosis of LN, (29) these clinical presentations are not suitable for establishing the true incidence of LN.
In order to objectively demonstrate the epidemiologic prevalence rate of BPLN among patients with SLE and minimize the influence of differing renal biopsy rates, we specifically incorporated cohort studies in which renal biopsies were performed routinely on most patients with LN.
The sex distribution and ages of patients with BPLN may also vary with ethnicity.
(7,8) The present study indicated that the prognosis of patients with BPLN had improved greatly during the past 20 years, although long-term survival remains unsatisfactory.
The present study also explored the risk factors for renal failure in patients with BPLN. Class IV glomerulonephritis was found to be the most frequent risk factor.
Incidence studies of BPLN from the all the population was not available.
In conclusion, to the best of our knowledge, this is the first meta-analysis to systematically review the epidemiologic characteristics of BPLN. Our findings demonstrate that LN is a common complication of young female patients with SLE, and is the most prevalent etiology of SGD in renal biopsy databases.
BPLN: Biopsy-proven lupus nephritis; SLE: Systemic lupus erythematosus.