Nonwhite Brazilian lupus nephritis case treatment and outcomes, based on APOL1 genotype.
| Variables | 0 APOL1 RRA, n = 170 | 1 APOL1 RRA, n = 27 | 2 APOL1 RRA, n = 4 | p 0 vs ≥ 1 RRA |
|---|---|---|---|---|
| Treatment | ||||
| First induction: CYC | 118 (70.2) | 18 (66.7) | 3 (75.0) | 0.83 |
| Maintenance: MMF | 141 (86.0) | 19 (76.0) | 3 (75.0) | 0.17 |
| HCQ at enrollment | 142 (84.0) | 20 (74.1) | 4 (100.0) | 0.43 |
| ACEi/ARB at enrollment | 118 (71.1) | 16 (64.0) | 3 (75.0) | 0.66 |
| Response after induction | ||||
| Complete or partial response at 6 mos | 85 (65.9) | 13 (56.5) | 1 (33.3) | 0.66 |
| Sustained eGFR < 60 ml/min/1.73 m2 at 6 mos | 6 (4.4) | 5 (21.7) | 0 | 0.018 |
| Complete or partial response at 12 mos | 104 (77.0) | 12 (57.1) | 2 (66.7) | 0.075 |
| Sustained eGFR < 60 ml/min/1.73 m2 at 12 mos | 9 (6.7) | 4 (19.0) | 0 | 0.11 |
| Complete or partial response at 24 mos | 91 (82.0) | 8 (61.5) | 3 (100) | 0.31 |
| Sustained eGFR < 60 ml/min/1.73 m2 at 24 mos | 8 (7.2) | 3 (23.1) | 0 | 0.14 |
| Outcomes at last followup | ||||
| Median SCr (25–75th), mg/dl | 0.80 (0.68–1.20) | 0.80 (0.60–3.00) | 1.45 (0.62–2.58) | 0.69 |
| Median eGFR (25–75th) | 97 (64.8–116.1) | 95 (20.9–118.9) | 72 (22.3–135.6) | 0.63 |
| Mean SAlb, mg/dl | 3.8 ± 0.54 | 3.8 ± 0.55 | 3.7 ± 0.48 | 0.47 |
| Median proteinuria (25–75th), g/day | 0.40 (0.15–1.20) | 0.49 (0.20–1.67) | 0.13 (0.11–0.76) | 0.74 |
| Complete or partial response | 121 (71.1) | 17 (63.0) | 2 (50.0) | 0.29 |
| Flare after response | 65 (47.8) | 8 (44.4) | 1 (33.3) | 0.82 |
| Refractory nephritis | 23 (13.6) | 8 (29.6) | 0 | 0.10 |
| eGFR < 60 ml/min/1.73 m2 | 40 (23.5) | 8 (29.6) | 0 | 0.82 |
| eGFR < 30 ml/min/1.73 m2 | 19 (11.2) | 8 (29.6) | 2 (50.0) | 0.005 |
| ESRD | 10 (5.9) | 7 (25.9) | 0 | 0.007 |
| Median time to ESRD (25–75th), mos | 114 (36–220) | 14 (9–22) | 0 | 0.002 |
Data are n (%) unless otherwise indicated. Data in bold face are statistically significant. ACEi: angiotensin-converting enzyme inhibitor; ARB: angiotensin receptor blocker; ESRD: endstage renal disease; MMF: mycophenolate mofetil; RRA: renal risk allele; eGFR: estimated glomerular filtration rate; SCr: serum creatinine; SAlb: serum albuminemia; HCQ: hydroxychloroquine; CYC: cyclophosphamide.