Nefropatía Lúpica: Aspectos clínicos y alternativas terapéuticas
The aim of the study was to examine the evolution of lupus nephropathy and its response to treatment in patients under control at the Servicio de Nefrología and Renal Transplantation of the HUC from 2000 to 2010. Methods: 280 patients with lupus nephropathy were followed retrospectively. Epidemiolog...
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2015
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| Online Access: | http://hdl.handle.net/10872/8053 |
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| Summary: | The aim of the study was to examine the evolution of lupus nephropathy and its response to treatment in patients under control at the Servicio de Nefrología and Renal Transplantation of the HUC from 2000 to 2010. Methods: 280 patients with lupus nephropathy were followed retrospectively. Epidemiologic and clinical variables (SLEDAI, AH, GFRe, proteinuria, ANA, Anti-DNA antibodies, C3, C4, and renal histopathology) were examined. Results: 92.9% of the patients were female with an age range of 35 to 45 years. According to GFRe, 60% of the patients were in CKD stage 1, 46% in stage 2, 20.7% in stage 3 and 4.6% in stages 4 and 5. Proteinuria ranging 0.5 to 1.05 gr/24 hours was present in 62.9% of patients, whereas 37.2% showed proteinuria greater than 3.5 gr/24 hours. Most patients had strongly positive ANA and anti-DNA antibodies, and low levels of C3 and C4. Severe SLEDAI was observed in 60.7% of the subjects. Kidney biopsy performed in 54.3% of the patients showed class IV nephropathy as the most prevalent (38%). Of these, 51.32% received 8 to 12 boluses of IV ciclophosphamide, and corticosteroids. Response to treatment as assessed by decrease of proteinuria and improvement or stabilization of eGFR was good in the majority of patients. Whereas, progression to CKD stage 5 occurred in 6.7% of the cases. Infection complications occurred in 7.1% of patients. Total mortality was 4.2%. Conclusions: Treatment of lupus nephritis with IV ciclophosphamide is effective to control both, nephropathy and systemic activity of SLE. |
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