Lupus nephritis in Indigenous Australians: a single-centre study

Nigam, Amit, Baer, Richard, Green, Stella, Neuen, Brendon L., Vile, Alexander, and Mantha, Murty (2020) Lupus nephritis in Indigenous Australians: a single-centre study. Internal Medicine Journal, 50 (7). pp. 830-837.

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Abstract

Background

The incidence, presentation and outcomes of lupus nephritis (LN) vary with geography, ethnicity, socioeconomic status and gender. There are relatively few data on LN in the non-Caucasian populations in Australia.

Aims

To describe the clinical presentation, histological features, natural history, and outcomes of a historical cohort of Aboriginal and Torres Strait Islanders people in Far North Queensland with biopsy-proven LN.

Methods

This is a retrospective observational study, and the study was conducted in Cairns and Hinterland Hospital and Health Service, Queensland, Australia. The study included Aboriginal and Torres Strait Islander patients with biopsy-proven LN treated between 1990 and 2013. The main outcome measures were renal replacement therapy and overall patient survival.

Results

Aboriginal and Torres Strait Islander people represented a substantial proportion (n = 16/40, 40%) of all patients diagnosed with LN during the observation period. The frequency of nephrotic range proteinuria (n = 11/14, 78.5%), estimated glomerular filtration rate <60 mL/min/1.73 m(2) (n = 6/14, 42.8%) and proliferative LN (n = 13/16, 81.25%) was high at the time of presentation. Despite use of multiple immunosuppressive agents, the overall rate of remission was poor (n = 4/14, 28.5%) and incidence of end-stage kidney disease (n = 4/14, 28.5%) and death (n = 5/16, 31.25%) was high.

Conclusions

The clinical presentation of LN in Aboriginal and Torres Strait Islanders in Far North Queensland is severe and the response to standard immunosuppressive therapy is unsatisfactory. Larger prospective multi-centre studies are required to better understand ethnic disparities in prognosis and response to immunosuppressive therapy in this specific population.

Item ID: 63901
Item Type: Article (Research - C1)
ISSN: 1445-5994
Keywords: nephrology, Indigenous Australian, lupus nephritis, systemic lupus erythematosus, chronic kidney disease, Aboriginal and Torres Strait Islander
Copyright Information: © 2019 Royal Australasian College of Physicians
Date Deposited: 29 Jul 2020 07:39
FoR Codes: 45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450499 Aboriginal and Torres Strait Islander health and wellbeing not elsewhere classified @ 100%
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