title: Lupus nephritis in Chinese children--a territory-wide cohort study in Hong Kong.
abstract: We report a multicenter study of Chinese children in Hong Kong with systemic lupus erythematosus (SLE) nephritis. Children were included if: they fulfilled the ACR criteria, had significant proteinuria or casturia, were Chinese and younger than 19 years and had been diagnosed with SLE between January 1990 and December 2003. Investigators in each center retrieved data on clinical features, biopsy reports, treatment and outcome of these patients. There were 128 patients (eight boys, 120 girls; mean age: 11.9+/-2.8 years). About 50% presented with multisystem illness and 40% with nephritic/nephrotic symptoms. Negative anti-dsDNA antibodies were found in 6% of the patients. Renal biopsy revealed WHO Class II, III, IV and V nephritis in 13 (10%), 22 (17%), 69 (54%) and 13 (10%) patients, respectively. The clinical severity of the nephritis did not accurately predict renal biopsy findings. The follow-up period ranged from 1 to 16.5 years (mean+/-SD: 5.76+/-3.61 years). During the study five patients died (two from lupus flare, one from cardiomyopathy, two from infections). Four patients had endstage renal failure (ESRF) (one died during a lupus flare). All deaths and end-stage renal failure occurred in the Class IV nephritis group. Chronic organ damage was infrequent in the survivors. The actuarial patient survival rates at 5, 10 and 15 years of age were 95.3, 91.8, and 91.8%, respectively. For Class IV nephritis patients, the survival rates without ESRF at 5, 10, and 15 years were 91.5, 82.3 and 76%, respectively. The survival and chronic morbidity rates of the Chinese SLE children in the present study are comparable to those of other published studies.
authors.affiliation: Department of Paediatrics & Adolescent Medicine, Tuen Mun Hospital, Tsing Chung Koon Road, Tuen Mun, Hong Kong, People's Republic of China. snwong@hkucc.hku.hk
authors.forename: Sik-Nin
authors.initials: SN
authors.lastname: Wong
authors.forename: Kei-Chiu
authors.initials: KC
authors.lastname: Tse
authors.forename: Tsz-Leung
authors.initials: TL
authors.lastname: Lee
authors.forename: Kwok-Wai
authors.initials: KW
authors.lastname: Lee
authors.forename: Stella
authors.initials: S
authors.lastname: Chim
authors.forename: Kwok-Piu
authors.initials: KP
authors.lastname: Lee
authors.forename: Reann
authors.initials: R
authors.lastname: Wai-Po Chu
authors.forename: Winnie
authors.initials: W
authors.lastname: Chan
authors.forename: Kwok-Wah
authors.initials: KW
authors.lastname: Fong
authors.forename: Joannie
authors.initials: J
authors.lastname: Hui
authors.forename: Samantha
authors.initials: S
authors.lastname: Po-Siu Li
authors.forename: Pa-Shing
authors.initials: PS
authors.lastname: Yeung
authors.forename: So-Fun
authors.initials: SF
authors.lastname: Yuen
authors.forename: Assunta
authors.initials: A
authors.lastname: Chi-Hang Ho
authors.forename: Lettie
authors.initials: L
authors.lastname: Chuk-Kwan Leung
authors.forename: David
authors.initials: D
authors.lastname: Luk
authors.forename: Pak-Chiu
authors.initials: PC
authors.lastname: Tong
authors.forename: Shu-Yan
authors.initials: SY
authors.lastname: Chan
authors.forename: Hon-Ming
authors.initials: HM
authors.lastname: Cheung
authors.forename: Chung-Mo
authors.initials: CM
authors.lastname: Chow
authors.forename: David
authors.initials: D
authors.lastname: Lau
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008181:Lupus Nephritis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008297:Male; D015996:Survival Rate