Table 3.
Non-white Brazilian lupus nephritis case treatment and outcomes, based on APOL1 genotype.
| 0 APOL1 RRA n=170 | 1 APOL1 RRA n=27 | 2 APOL1 RRA n=4 | P-value 0 vs ≥1 RRA | |
|---|---|---|---|---|
| Treatment | ||||
| First Induction: Cyclophophamide, n (%) | 118(70.2) | 18(66.7) | 3(75.0) | 0.83 |
| Maintenance: Mycophenolate Mofetil, n (%) | 141(86.0) | 19(76.0) | 3(75.0) | 0.17 |
| Hydroxychloroquine at enrollment, n (%) | 142(84.0) | 20(74.1) | 4(100.0) | 0.43 |
| ACEi/ARB at enrollment, n (%) | 118(71.1) | 16(64.0) | 3(75.0) | 0.66 |
| Response after induction | ||||
| Complete or partial response at 6mos, n (%) | 85 (65.9) | 13(56.5) | 1(33.3) | 0.66 |
| Sustained eGFR <60 ml/min/1.73m2 at 6 mos, n (%) | 6(4.4) | 5(21.7) | 0 | 0.018 |
| Complete or partial response at 12mos, n (%) | 104(77.0) | 12(57.1) | 2(66.7) | 0.075 |
| Sustained eGFR <60 ml/min/1.73m2 at 12 mos, n (%) | 9(6.7) | 4(19.0) | 0 | 0.11 |
| Complete or partial response at 24mos, n (%) | 91(82.0) | 8(61.5) | 3(100) | 0.31 |
| Sustained eGFR <60 ml/min/1.73m2 at 24 mos, n (%) | 8(7.2) | 3(23.1) | 0 | 0.14 |
| Outcomes at last follow-up | ||||
| 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, n (%) | 121(71.1) | 17(63.0) | 2(50.0) | 0.29 |
| Flare after response, n (%) | 65(47.8) | 8(44.4) | 1(33.3) | 0.82 |
| Refractory nephritis, n (%) | 23(13.6) | 8(29.6) | 0 | 0.10 |
| eGFR <60 ml/min/1.73m2, n(%) | 40(23.5) | 8(29.6) | 2(50.0) | 0.37 |
| eGFR <30 ml/min/1.73m2, n (%) | 19(11.2) | 8(29.6) | 2(50.0) | 0.005 |
| ESRD, n (%) | 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 |
Abbreviations: ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor antagonist; ESRD, end stage kidney disease.