THE IMPACT OF CUMULATIVE ANEMIA EXPOSURE ON THE RISK OF RENAL DAMAGE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Notice bibliographique
Résumé
PV241 / #806 Poster Topic: AS23 - SLE-Diagnosis, Manifestations, & Outcomes Background/Purpose Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that can involve multiple organ systems, including the kidneys, blood, and skin. Lupus Nephritis (LN) is the most severe complication of SLE, with treatment objectives aimed at preventing chronic kidney disease (CKD) and End-Stage Renal Disease (ESRD), optimizing quality of life, and improving survival. Anemia is the most common hematologic complication in SLE and is closely associated with disease activity, multiorgan dysfunction, and particularly the progression of renal damage. However, mild to moderate anemia has long been neglected in the diagnosis and management of SLE, and there is limited research on the impact of cumulative anemia exposure on renal damage in SLE patients. This study aims to utilize 12 years of natural follow-up data from SLE patients at Xiangya Hospital to conduct a real-world retrospective cohort study investigating the impact of cumulative anemia exposure on the risk of renal damage in SLE patients. Methods A study cohort was established using data from SLE patients with confirmed diagnoses who were treated at Xiangya Hospital between January 2010 and June 2022. Longitudinal hemoglobin (Hb) concentration data were used to construct hemoglobin concentration-time curves, and variables such as average hemoglobin concentration, proportion of anemia duration, and cumulative anemia exposure were defined. New-onset CKD and ESRD were selected as outcome indicators for survival analysis. Multivariable Cox regression models were employed to explore the effects of these anemia-related variables on the development of CKD and ESRD in SLE patients, with adjustments made for known renal prognostic risk factors. Subgroup analyses were conducted for LN patients. Sensitivity analyses examined the relationship between the proportion of mild, moderate, and severe anemia duration and the risks of CKD and ESRD. Restricted cubic spline Cox regression models were used to investigate the dose-response relationships between cumulative anemia exposure variables and the risks of CKD and ESRD. Results A total of 2,361 SLE patients were included in the study, with 88.1% being female. The median age was 33 years, and the median follow-up time was 57.5 months. Among these patients, 52% had LN, and the baseline mean estimated glomerular filtration rate (eGFR) was 98.5 ± 27.8 mL/min/1.73 m². Cox analysis revealed that an average hemoglobin concentration below the anemia threshold increased the risk of CKD by 6.18-fold and ESRD by 14.14-fold in SLE patients. Cumulative anemia exposure greater than 0 was associated with a 2.24-fold increased risk of CKD and a 9.46-fold increased risk of ESRD. Among LN patients, the associations between average hemoglobin concentration, cumulative anemia exposure, and the risks of CKD and ESRD were more pronounced. Sensitivity analyses showed that a proportion of moderate anemia duration greater than 0 significantly increased the risks of CKD and ESRD in both SLE and LN patients. Restricted cubic spline analysis indicated that the risks of CKD and ESRD increased with longer anemia duration and greater cumulative anemia exposure. Conclusions Prolonged anemia exposure is strongly associated with renal damage. Reducing the duration of moderate anemia and cumulative anemia exposure may serve as effective targets for improving renal outcomes in SLE patients.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».