Pan-immune-inflammation value (PIIV) in Lupus Nephritis PIIV as a predictor of reduced GFR
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Objective: Pan-immune-inflammation value (PIIV) is a newly defined marker that has been validated to predict the prognosis of several oncological diseases. We investigated whether PIIV at diagnosis could predict a reduced glomerular filtration rate (GFR) during follow-up in patients with lupus nephritis (LN).
Material and Methods: We included 45 patients with biopsy-proven LN in this case-control study. PIIV at the diagnosis was calculated for each patient before starting any immunomodulatory and/or immune-suppressive drugs. The study group was classified into two subgroups: patients with a minimum 10 % decreased glomerular filtration rate (GFR) from baseline or preserved GFR. LN-specific indices, inflammation-related laboratory results at diagnosis, medications and developing comorbidities at the follow-up were also noted. Chi-Square Test was used to compare the subgroups. Associated factors were analyzed by logistic regression analysis. Statistically, the significance level was accepted as p˂0.05.
Results: 77.8 % of all patients (n=35) were female, whereas 22.2 % were male. The mean age of the study group was 33.0 ± 13.4 years. The median follow-up period was 36 months (range: 4-108 months). A vast majority of patients (n=32, 71.1%) had class IV LN. GFR reduction was observed in eleven patients (n=11). The mean age at diagnosis, presence of developing hypertension, mean PIIV value, and PIIV >75% were significantly higher in patients with decreased GFR than the patients with preserved GFR (p=0.019, p=0.044, p=0.015, and p=0.011, respectively). In addition, the presence of developing HT and PIIV >75% were found to be statistically significant factors in the multivariate model (p=0.029 and p=0.022).
Conclusion: An increased PIIV at baseline was independently associated with a reduction in GFR in LN patients. A high PIIV might become a new biomarker for the risk of GFR reduction and the need for improved/intensive treatment of these patients.
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