Identification of novel classes for patients with lupus nephritis using two-step cluster model

Wien Klin Wochenschr. 2022 Mar;134(5-6):202-207. doi: 10.1007/s00508-021-02001-y. Epub 2022 Jan 17.

Abstract

Objective: To identify and reclassify the patients in the lupus nephritis (LN) cohort, and to further analyze the prominent clinical features and clinical significance of each cluster.

Methods: In this retrospective cross-sectional study, we used a two-step clustering method to classify 635 patients with LN into different clusters, then we observed the main differences and analyzed relevant clinical significance between the clusters.

Results: Cluster 1 (20.5%) presented with the highest disease severity, patients in this group had the disease for a longer duration and higher systemic lupus erythematosus disease activity index (SLEDAI) score, with multiple positive auto-antibodies and lower complement level. Patients of cluster 2 (20.8%) had lower levels of IgG, IgA and IgM, with renal function being relatively worse in this cluster than in clusters 1 and 3. Cluster 3 was the largest group (58.7%), and the patients in this group showed mild disease severity.

Conclusion: This study reclassified LN patients in a large cohort into three clusters. Our classification might be helpful to implement targeted therapy at various stages of systemic lupus erythematosus.

Keywords: Anti-nuclear antibody; Cohort; Damage index; Erythematosus; Immunoglobulin.

MeSH terms

  • Cross-Sectional Studies
  • Humans
  • Lupus Erythematosus, Systemic* / diagnosis
  • Lupus Nephritis* / diagnosis
  • Retrospective Studies
  • Severity of Illness Index