MO215DEPRESSIVE DISORDER IN LUPIC PATIENTS WITH LUPUS NEPHRITIS: DATA FROM A POPULATION OF 67 PATIENTS WITH BIOPSY PROVEN LUPUS NEPHRITIS

Abstract

Abstract Background and Aims Systemic lupus erythematosus is a multi-organ, multi-systemic autoimmune disease with significant burden on generally young patients. Renal involvement is relatively frequent, recent studies cite a prevalence of 15-60% of patients, and 25% develop end-stage renal disease after 10 years of disease onset. We studied the incidence of depressive disorders in a population of 67 patients with biopsy proven lupus nephritis. Data about depression in patients with renal involvement of lupus is still scarce. We identified variables associated with the development of depressive disorders in lupus patients. Method We concluded a single center transversal study to assess the incidence of depressive disorder in patients with biopsy proven lupus nephritis. We used the self-report Beck Depression/ Anxiety Inventory (BDI/ BAI), 1961/ 1990, translated in Romanian and validated in the Romanian population to diagnose depression. We also wanted to identify risk factors associated with depression in such patients. We used EpiInfo for the statistical analysis and data was extracted from medical records. Results We included in the study patients diagnosed with systemic lupus erythematosus, and had renal biopsy between January 2008 – December 2018. Patients were followe-up until May 2020. Beck Depression/Anxiety Inventory was administered a single time during the follow-up visit between (March 2019 – May 2020). In our study group, 58 patients were female (86.5%). Median age at diagnosis of lupus disease was 29 years (min 10 years, max 62 years). Median duration of the disease until the self-assessment inventory was 10 years (min 1.5 years, max 30 years). Median duration of corticosteroid treatment was 10.1 years (min 1.58 years, max 29). 1 patient had class I, 2 had class II, 12 had class III, 32 had class IV, 12 had class V, 1 had class VI, 1 had classes III+V, 1 had classes IV+V of lupus nephritis (ISN classification of lupus nephritis). 13 patients had normal scores of the Beck Inventory (0-9 points), 7 had mild depression (10 - 15 points), 37 had moderate depression (16- 23 points), 10 had severe depression (24-63 points). We identified female gender (p=0.009), duration of corticosteroid therapy (p=0.036), duration of the lupic disease (p=0.036) to be independently associated with depression development. Other variables, such as creatinine levels at the moment of the assessment, duration of maintenance therapy with mycofenolate mofetil or azathioprine, proteinuria, inflammatory markers were not associated significantly with depression. Conclusion We identified clinical variables associated with depression development in patients with lupus nephritis. The study brings data useful for the clinician, helping doctors focus on the variables that predict depression in lupus patients and making screening for depressive disorders more focused on the patients with risk factors.