Caracterización de los pacientes menores de 18 años con nefritis lúpica en el Hospital Pablo Tobón Uribe y en el Hospital San Vicente Fundación de la ciudad de Medellín, entre 2008 y 2017

Abstract

IntroductionThe kidney is one of the organs frequently affected in systemic lupus erythematosus (40-60%); the manifestations are variable, from a silent pattern to the irreversible impairment of renal function. Objetives•To characterize patients under 18 years of age with a diagnosis of lupus nephritis treated at the Pablo Tobón Uribe Hospital and San Vicente Fundación Hospital during the years 2006 to 2017.•Establish the frequency of lupus nephritis in patients diagnosed with childhood systemic lupus erythematosus.•Describe the general, sociodemographic, clinical and paraclinical characteristics, as well as histopathological characteristics, immunosuppressive treatment and complications such as chronic kidney disease, high blood pressure, need for renal replacement therapy and death in patients diagnosed with lupus nephritis.•Explore the association between lupus nephritis with a histological pattern defined as moderate or severe and chronic kidney disease, arterial hypertension, need for renal replacement therapy and death. Materials and methodsDescriptive study with retrospective information in a group of patients under 18years of age with a diagnosis of lupus nephritis, attended in two referral centres of the city of Medellin between 2008 and 2017. Clinical records of patients who met the inclusion criteria were reviewed. ResultsThe median age was 13 years, with predominance in females. The majority had renal involvement at the time of diagnosis of lupus. Histological classIV was the most frequent (48%). Age under 10years, absence of response to induction therapy, and histological classIV, were related to the development of chronic kidney disease (>60ml/min/1.73m2). ConclusionsRenal involvement was higher in this study. Age, classIV, and non-response to induction were associated with impaired renal function.