Abstract: PO2328
Effect of Hypertension on Childhood-Onset Systemic Lupus Erythematous in a Tertiary Medical Center in Korea
Session Information
- Pediatric Nephrology: Glomerular Disease and Transplantation
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1700 Pediatric Nephrology
Authors
- Kim, Jeong yeon, Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
- Cho, Heeyeon, Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
Background
Hypertension (HTN) is prevalent in childhood-onset systemic lupus erythematous (cSLE) and affected either by disease activity itself, cSLE medication or both. The purpose of this study is to evaluate the prevalence, clinical characteristics and long-term clinical effect of HTN in Korean cSLE patients treated in tertiary medical center in Korea.
Methods
The medical records of cSLE patients, diagnosed by 2019 SLE European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria, who visited Samsung Medical Center from January 2009 to May 2019 were reviewed retrospectively. The disease activity was evaluated by Modified Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and renal activity (renal SLEDAI) was measured by scores from SLDEA-2K. The long-term damage was evaluated by The Pediatric Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (Ped-SDI). The sex-, age- and height-blood pressure standards recommended by AAP 2017 guideline was used to define HTN. Left ventricular hypertrophy (LVH) was defined by sex, age specific left ventricular mass index (LVMI) ≥ 95th percentile.
Results
Total 32 patients were enrolled in this study. The median follow-up duration was 7.3 year and female was predominant. Median age at SLE and HTN diagnosis were 14.2 and 14.3 year, respectively. Initial renal involvement was detected in 12.5%. The biopsy proven LN was detected in 84.4% (n=28) and 37.5% of them were class IV (n=12). The prevalence of HTN, including 2 transient HTN, was 34.4% (n=11) and stage 2 HTN was prevalent (n=9). The median dose of steroids, converted to prednisolone, at diagnosis of SLE and HTN were 1.0mg/kg/day and 0.5mg/kg/day. Among cSLE patients with HTN, 2 patients had 3 episodes of posterior reversible encephalopathy syndrome. LVH was detected in 2 patients with HTN. In the cSLE patients with persistent HTN (n=9), lower eGFR (OR=0.9, p=0.031) and higher BMI (OR 1.4, p=0.047) were shown at the time of SLE diagnosis. Every patient with HTN - including transient HTN - in cSLE (n=11) showed lower eGFR at the time of SLE diagnosis (OR 0.9, p=0.029) and higher Ped-SDI (OR 1.8, p=0.047) at last visit.
Conclusion
In conclusion, HTN in cSLE is associated with BMI and renal function at SLE diagnosis. Also, HTN affect long term damage accumulation in cSLE.