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The course and long-term outcome of pure membranous lupus nephritis (MLN) are little understood. The aims of this study are to evaluate the clinical features, course, outcome and prognostic indicators in pure MLN and to determine the impact of ethnicity and the type of health insurance on the course and prognosis of pure MLN.
We conducted a retrospective review of medical records of 150 patients with pure MLN from Spain and the USA.
Mean age was 34.2±12.5 and 80% were women. Sixty-eight percent of patients had nephrotic syndrome at diagnosis. The average serum creatinine was 0.98±0.78mg/dl. Six percent of patients died and 5.3% developed end-stage renal disease (ESRD). ESRD was predicted by male sex, hypertension, dyslipidemia, high basal 24h-proteinuria, high basal serum creatinine and a low basal creatinine clearance. Age, cardiac insufficiency, peripheral artheriopathy, hemodialysis and not having received mycophenolate mofetil or antimalarials for MLN predicted death.
Pure MLN frequently presents with nephrotic syndrome, high proteinuria and normal serum creatinine. Its prognosis is favourable in maintaining renal function although proteinuria usually persists over time. Baseline cardiovascular disease and not having a health insurance are related with poor prognosis.
Fuente: Reumatol Clin. 2019 Jan - Feb;15(1):34-42
Editorial: Elsevier España
Año de publicación: 2019
Nº de páginas: 9
Tipo de publicación: Artículo de Revista
SILVA FERNÁNDEZ, LUCÍA
LÓPEZ LONGO, FRANCISCO JAVIER
RÚA FIGUEROA, ÍÑIGO
RUIZ LUCEA, ESTHER
ALEGRE SANCHO, JUAN JOSÉ
JAIME CALVO ALEN
VICTOR MANUEL MARTINEZ TABOADA