Factores clínicos e inmunológicos asociados con nefritis lúpica en una población de pacientes argentinos: un estudio transversal

Abstract

IntroductionIn recent decades, the prevalence of systemic lupus erythematosus (SLE) has increased thanks to early detection and the impact of new therapies on the survival of those affected. Up to 90% will have histopathological signs of kidney disease in the first 3 years of the disease, but lupus nephritis of clinical relevance will appear in 50% of cases, affecting kidney function and mortality. Despite aggressive therapeutic strategies, the prognosis of patients with LN remains unfavourable, mainly due to the high risk of progression to end-stage renal disease (10%-20%) and mortality from all causes. ObjectiveTo describe the clinical and immunological risk factors of a group of patients with lupus, comparing clinical and serological characteristics in relation to renal involvement to establish possible associations. Materials and methodsCross-sectional study in which 87 patients with SLE were included. Clinical and immunological variables were analysed. Bivariate and multivariate analyses were performed using the presence of nephritis as an outcome. ResultsThe prevalence of lupus nephritis was 59%. The significantly associated variables were arterial hypertension (OR 3.1, 95% CI 1.02-9.40), age of onset of lupus less than 25 years (OR 2.7, 95% CI 1.08-6.73), the presence of reticular livedo (OR 4.1, 95% CI 1.09-15.7), positive anti-DNA (OR 2.9, 95% CI 1.18-7.24) and low levels of complement (OR 4.0, 95% CI 1.64-10.2.). ConclusionsUrinary sediment abnormalities were the most common renal manifestation and lupus debut before the age of 25 seems to increase the risk of developing nephritis. Future research is required for a better explanation of the associations found.