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Abstract: Objectives: Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus (SLE). Unfortunately, 10-20% of patients with LN develop end-stage renal disease (ESRD), and renal transplantation may be a therapeutic option. However, concerns about LN recurrence after transplant have been reported. We aimed to assess long-term post-transplant graft and patient survival in LN compared to patients with non-autoimmune nephropathy (polycystic kidney disease - PCKD).
Methods: We carried out a single-centre retrospective study of all patients who underwent renal transplantation due to LN in a referral unit between 1980 and 2018. This cohort was compared with a group of PCKD patients. The main outcome variables were graft and patient survival for up to 20 years, and the time-course of serum creatinine and proteinuria in the first 5 years after transplantation. Cumulative survival rates were estimated by the Kaplan-Meier method and compared using the log-rank test.
Results: We included 53 patients: LN group (n=21) and PCKD group (n=32). Baseline clinical characteristics were similar in both groups, except age at transplantation (39.8±11.3 years in the LN group and 46.6±5.0 years in the PCKD group; p=0.004). No significant differences were found regarding graft (p=0.59) or patient survival (p=0.087) at 20 years of follow-up.
Conclusions: Despite concerns about LN recurrence after renal transplantation, this study shows that this procedure might be a safe alternative therapy for ESRD related to SLE and may provide long-term survival.
Fuente: Clin Exp Rheumatol
. 2022 Mar;40(3):581-588
Editorial: Clinical and Experimental Rheumatology
Año de publicación: 2022
Nº de páginas: 8
Tipo de publicación: Artículo de Revista
Url de la publicación: https://www.doi.org/10.55563/clinexprheumatol/ri873i
COS-GÓMEZ, M. DE
EMILIO RODRIGO CALABIA
JUAN CARLOS RUIZ SAN MILLAN
JOSE JAVIER GOMEZ ROMAN
MIGUEL ANGEL GONZALEZ-GAY MANTECON
JOSE LUIS HERNANDEZ HERNANDEZ
RICARDO BLANCO ALONSO