J Rheum Dis 2018; 25(4): 239-247  
Antiphospholipid Antibody Positivity and the Clinical Outcomes of Patients with Systemic Lupus Erythematosus
Seoung Wan Nam1, Soo-Kyung Cho1, Dam Kim1, Kyung-Eun Lee2, Dong-Jin Park2, Shin-Seok Lee2, Yoon-Kyoung Sung1
1Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, 2Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju, Korea
Correspondence to: Yoon-Kyoung Sung, http://orcid.org/0000-0001-6691-8939
Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea. E-mail:sungyk@hanyang.ac.kr
Received: April 2, 2018; Revised: May 24, 2018; Accepted: June 9, 2018; Published online: October 1, 2018.
© Korean College of Rheumatology. All rights reserved.

This is a open Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Objective. To identify the prevalence of antiphospholipid antibodies (aPL) in systemic lupus erythematosus (SLE) patients and determine the relationship between aPL and the clinical outcomes. Methods. SLE patients with aPL test results within 2 years of enrollment were selected from Korean lupus network study. They were classified into two groups: aPL (+) group, patients positive for at least one aPL, and aPL (-) group, patients without an aPL. The clinical characteristics of the two groups were compared and the role of aPL in the risk of chronic kidney disease (CKD) in SLE patients was examined. Results. Among the 469 SLE patients, 69 (14.7%) had at least one aPL. The prevalence of cerebrovascular disease and CKD was higher in the aPL (+) group than in the aPL (-) group (10.1% vs. 1.8% and 13.8% vs. 5.1%, p<0.05). Multivariable regression analysis showed that the aPL positivity (odds ratio=3.93, 95% confidence interval=1.48∼10.47) was associated with the risk of CKD after adjusting for age, disease duration, and lupus nephritis history. Conclusion. The prevalence of aPL in Korean SLE patients is 14.7%, and it is associated with a higher prevalence of cerebrovascular disease and CKD in SLE patients. The aPL positivity is independently associated with the risk of CKD in SLE patients.
Keywords: Antiphospholipid antibody, Systemic lupus erythematosus, Chronic kidney disease


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