Abstract

Research Article

Prognostic factors for chronic kidney disease and end-stage renal disease in patients with lupus nephritis: A retrospective cohort study

Fernanda Nogueira Holanda Ferreira Braga*, Marta Maria das Chagas Medeiros, Antônio Brazil Viana Jr., Levi Coelho Maia Barros, Marcelo Ximenes Pontes, Matheus Eugênio de Sousa Lima, Allyson Wosley de Sousa Lima and Paula Frassinetti Castelo Branco Camurça Fernandes

Published: 27 April, 2021 | Volume 5 - Issue 1 | Pages: 034-041

Background: Lupus Nephritis (LN) occurs in approximately half of all patients with Systemic Lupus Erythematosus (SLE) and it is the most common cause of morbidity and mortality in patients with SLE. Factors associated with poor renal outcome vary among studies, and researches coming from Brazil are scarce.

Objectives: To identify the prognostic factors associated to the development of Chronic Kidney Disease (CKD) and End Stage Renal Disease (ESRD) in LN patients followed in a tertiary hospital.

Design and Settings: We conducted a retrospective cohort study set in a tertiary hospital in Fortaleza, Ceará, Brazil. Methods: We compiled a total of 214 LN patients diagnosed between 1983 and 2015. Data was collected from medical records and further analyzed using logistic regression.

Results: LN prevalence was 53.9%. The cohort had a mean follow-up of 11.2 years (SD ± 7.2 years). At the end of follow-up, 93 of 197 patients (47.2%) had CKD, and 49 of 191 (25.6%) were on regular dialysis. The main factors associated for developing CKD after logistic regression analysis were the following predictors: hypertension (HR 2.80; 95% CI 1.30-6.01; p = 0.008), time between diagnosis of SLE and diagnosis of LN (HR 0.98; 95% CI 0.97-0.99; p = 0.009) and discontinuation of medications (HR 2.41; 95% CI 1.08-5.37; p = 0.03).

Conclusion: Hypertension, discontinuation of medications, and time between diagnosis of SLE and diagnosis of LN are independent variables associated with the development of CKD and ESDR in our study. 

Read Full Article HTML DOI: 10.29328/journal.jcn.1001071 Cite this Article Read Full Article PDF

Keywords:

Lupus; Lupus nephritis; Prognostic features; Epidemiology; Mesh terms: Nephritis, Lupus; End Stage Renal Disease; Chronic Kidney Disease; Risk Factor

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