Characteristics and outcomes of a Hispanic lupus nephritis cohort from Mexico

Abstract

Objectives To characterize the clinical presentation and outcomes of lupus nephritis (LN) in a Hispanic cohort from Mexico. Methods We studied 440 subjects with systemic lupus erythematosus and biopsy-proven LN followed for >36 months. We obtained demographic, clinical, laboratory, histopathological, and treatment variables. All outcomes were analysed by survival analysis and included response to therapy, renal relapses, progression of kidney disease (decline in eGFR ≥ 30%, doubling of serum creatinine, end-stage kidney disease), and patient survival. Results The median age of the study cohort was 29 years (IQR 23–37), and 96% were female. The median eGFR at inclusion was 81 mL/min/1.73m2 (IQR 48–118), and 24 h-uPCR was 3.4 g/g (IQR 1.9–5.6). Mixed class LN (III/IV+V) was the most frequently observed (69%). Over a median follow-up of 79 months, complete response rates were 22.3%, 40.5%, and 51.6%, at 6-, 12-, and 24-months, respectively. Renal relapse rates were 32.3% and 50.6% at 3- and 5-years. By 3- and 5-years, 20.7% and 31.4% had decline in eGFR ≥30%, 14.4% and 22.5% doubled their serum creatinine, and 9.1% and 17.7% progressed to ESKD. The factors associated with loss of kidney function were age, eGFR at presentation, the histologic chronicity index in the kidney biopsy, and the type of response to therapy. Patient survival was 98.2% and 97.1% at 3- and 5-years. Conclusion Although the response to treatment and patient survival in this Latin American cohort is comparable to that observed in other regions, there is still a high rate of renal relapses and progression to decline in kidney function.

Clinical features and genetic biomarkers associated with different phenotypes of systemic lupus erythematosus in Paraguayan patients

“…Lupus nephritis (LN), the most worrisome manifestation of SLE, is significantly more frequent in them (24)(25)(26)(27). This coincides with our study, which included the Hispanic mestizo population, where we observed that the most frequent identified phenotype was renal.…”

Study on Some Parameters and Anti-Rubella Igg in A Sample of Systemic Lupus Erythematosus Patients

“…Assessment of some immunological markers in Iraqi patients with Systemic Lupus Erythematosus and Lupus Nephritis (LN) showed increased levels of blood urea (BU) and creatinine (Cr), in groups of patients (SLE with LN, SLE without LN) in comparison with controls (14) . A recent study proved that one of the factors associated with loss kidney function was doubled their serum creatinine (15) . SLErelated hepatitis (LH) is a separate entity that affects 3-8% of SLE patients and is characterized by subclinical and slight elevations of liver enzymes.…”

Kidney Biopsy in Management of Lupus Nephritis: A Case-Based Narrative Review

“… 48 , 49 , 50 In contrast, patients with partial response, usually defined as stable kidney function and a 50% decrease in proteinuria, still have a 50% probability of progressing to kidney failure, either by an increased risk for renal relapses or by persistent kidney inflammatory activity. 46 , 51 , 52 , 53 …”