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Background <p>There exists a significant population of lupus nephritis (LN) patients in China, and acute kidney injury (AKI) represents the prevalent complication associated with LN. Our study is aimed at investigating the risk factors for AKI in Chinese patients with LN through a meta-analysis.</p> Methods <p>A comprehensive literature search was performed using PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wangfang, VIP, and SinoMed, encompassing studies from the inception of each database through January 2024. EndNote v20.0 was employed for reference management, Newcastle-Ottawa Scale was utilized for quality assessment. R v4.3.2 was used for data analysis and visualization. Subgroup analysis, sensitivity analysis, and publication bias evaluation were carried out to verify the robustness of the results.</p> Results <p>Nineteen articles were included in our study, comprising 4305 patients, 1434 in the AKI group and 2871 in the no-AKI group. Male (OR = 1.43, 95% CI: 1.08–1.88), infection (OR = 3.35, 95% CI: 2.37–4.74), hypertension (OR = 1.27, 95% CI: 1.04, 1.56), serositis, positive for SSB antibody (OR = 1.54, 95% CI: 1.17–2.04), and renal pathology type IV (OR = 3.81, 95% CI: 2.43–5.98) were identified as risk factors for AKI in patients with LN. Additionally, high disease activity and markers of systemic damage were associated with increased risk of AKI, including hematuria (OR = 2.01, 95% CI: 1.21–3.25), anemia(OR = 2.65, 95% CI: 1.86–3.79), high 24-hour U-Pro levels (MD = 1.81, 95% CI: 1.10–2.52), positive for ds-DNA antibody (OR = 1.70, 95% CI: 1.41–2.07), and high SLEDAI (MD = 3.09, 95% CI: 2.01–4.16). Low disease activity characterized by high serum albumin levels and high C3 levels decreased risk of AKI. While there were differences from the studies, their impact on the results was minimal, and no significant publication bias was detected.</p> Conclusion <p>The risk factors for AKI in patients with LN were evaluated in this research, and data support was provided for clinical risk assessment. To facilitate personalized diagnosis and treatment for patients with multiple risk factors simultaneously and optimize therapeutic measures for protecting kidney function.</p>

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Risk factors for acute kidney injury in Chinese patients with lupus nephritis: a meta-analysis

  • 期刊论文

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  • 发表日期：

    2026年1月27日

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  • Qiang Zhang,
  • Xiao Yuan,
  • Weizhe Deng,
  • Zhihui Xu,
  • Pengyu Zhang,
  • Sining Wang,
  • Guoyang Shi,
  • Chunsheng Qian

摘要

Background

There exists a significant population of lupus nephritis (LN) patients in China, and acute kidney injury (AKI) represents the prevalent complication associated with LN. Our study is aimed at investigating the risk factors for AKI in Chinese patients with LN through a meta-analysis.

Methods

A comprehensive literature search was performed using PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wangfang, VIP, and SinoMed, encompassing studies from the inception of each database through January 2024. EndNote v20.0 was employed for reference management, Newcastle-Ottawa Scale was utilized for quality assessment. R v4.3.2 was used for data analysis and visualization. Subgroup analysis, sensitivity analysis, and publication bias evaluation were carried out to verify the robustness of the results.

Results

Nineteen articles were included in our study, comprising 4305 patients, 1434 in the AKI group and 2871 in the no-AKI group. Male (OR = 1.43, 95% CI: 1.08–1.88), infection (OR = 3.35, 95% CI: 2.37–4.74), hypertension (OR = 1.27, 95% CI: 1.04, 1.56), serositis, positive for SSB antibody (OR = 1.54, 95% CI: 1.17–2.04), and renal pathology type IV (OR = 3.81, 95% CI: 2.43–5.98) were identified as risk factors for AKI in patients with LN. Additionally, high disease activity and markers of systemic damage were associated with increased risk of AKI, including hematuria (OR = 2.01, 95% CI: 1.21–3.25), anemia(OR = 2.65, 95% CI: 1.86–3.79), high 24-hour U-Pro levels (MD = 1.81, 95% CI: 1.10–2.52), positive for ds-DNA antibody (OR = 1.70, 95% CI: 1.41–2.07), and high SLEDAI (MD = 3.09, 95% CI: 2.01–4.16). Low disease activity characterized by high serum albumin levels and high C3 levels decreased risk of AKI. While there were differences from the studies, their impact on the results was minimal, and no significant publication bias was detected.

Conclusion

The risk factors for AKI in patients with LN were evaluated in this research, and data support was provided for clinical risk assessment. To facilitate personalized diagnosis and treatment for patients with multiple risk factors simultaneously and optimize therapeutic measures for protecting kidney function.