Abstract: The aim of the study was to profile those patients included in
the RELESSER registry with histologically proven renal involvement
in order to better understand the current state of lupus nephritis (LN) in
Spain.
RELESSER-TRANS is a multicenter cross-sectional registry with
an analytical component. Information was collected from the medical
records of patients with systemic lupus erythematosus who were
followed at participating rheumatology units. A total of 359 variables
including demographic data, clinical manifestations, disease activity,
severity, comorbidities, LN outcome, treatments, and mortality were
recorded. Only patients with a histological confirmation of LN were
included.We performed a descriptive analysis, chi-square or Student?s t
tests according to the type of variable and its relationship with LN. Odds
ratio and confidence intervals were calculated by using simple logistic
regression.
LN was histologically confirmed in 1092/3575 patients (30.5%).
Most patients were female (85.7%), Caucasian (90.2%), and the mean
age at LN diagnosis was 28.412.7 years. The risk for LN development
was higher in men (M/F:47.85/30.91%, P<0.001), in younger individuals
(P<0.001), and in Hispanics (P¼0.03). Complete response to
treatment was achieved in 68.3% of patients; 10.35% developed ESRD,
which required a kidney transplant in 45% of such cases. The older the
patient, the greater was the likelihood of complete response (P<0.001).
Recurrences were associated with persistent lupus activity at the time of
the last visit (P<0.001) and with ESRD (P<0.001). Thrombotic
microangiopathy was a risk factor for ESRD (P¼0.04), as for the
necessity of dialysis (P¼0.01) or renal transplantation (P¼0.03). LN
itself was a poor prognostic risk factor of mortality (OR 2.4 [1.81?3.22],
P<0.001). Patients receiving antimalarials had a significantly lower
risk of developing LN (P<0.001) and ESRD (P<0.001), and
responded better to specific treatments for LN (P¼0.014).
More than two-thirds of the patients with LN from a wide
European cohort achieved a complete response to treatment. The
presence of positive anti-Sm antibodies was associated with a higher
frequency of LN and a decreased rate of complete response to treatment.
The use of antimalarials reduced both the risk of developing renal
disease and its severity, and contributed to attaining a complete renal
response.
Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria
Fuente: Medicine (Baltimore). 2016 Mar;95(9):e2891
Editorial: Lippincott Williams & Wilkins
Año de publicación: 2016
Nº de páginas: 11
Tipo de publicación: Artículo de Revista
DOI: 10.1097/MD.0000000000002891
ISSN: 0025-7974,1536-5964