Kidney Week

Abstract: PO1922

Analysis of Characteristics and Risk Factors of Sepsis in Patients with Lupus Nephritis

Session Information

• Glomerular Diseases: Clinical, Outcomes, and Trials - 3
  October 22, 2020 | Location: On-Demand
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

• Xu, Zhenjian, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China

Zhenjian Xu,

• Liang, Meisheng, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China

Meisheng Liang,

• Xu, Anping, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China

Anping Xu,

Background

Patients with lupus nephritis are at high risk of infection due to intrinsic immune dysregulation and treatment with glucocorticoids and immunosuppressants. Infection is a common complication in patients with lupus nephritis and is a major determinant of in-hospital mortality. Sepsis are the most frequent causes of infection-related mortality. In this research, we study the clinical characteristics and related risk factors of sepsis in patients with lupus nephritis according to a retrospective analysis.

Methods

A retrospective study was carried out for 322 hospitalized patients with lupus nephritis in Sun Yat-Sen Memorial Hospital from 2010 to 2019. The infected group consisted of 140 patients (The infected patients were subdivided into septic group and non-septic group according the sepsis criteria) while the non-infected group consisted of 182 patients without infection. Baseline data including sex, age, disease duration, hospitalization duration, associated organ involvement, use of glucocorticoid and immunosuppressants.

Results

Compared to the non-infected group, longer hospitalization duration（14 vs. 9d，P<0.05）, pulsed methylprednisolone treatment within 1 month（10.7% vs. 1.6%，P<0.05）, cyclophosphamide（22.9% vs. 14.3%，P<0.05）, and calcineurin inhibitors（18.6% vs. 10.4%，P<0.05）, and higher dose of oral corticosteroid（15 vs. 10mg，P<0.05）can be seen in the infected group (P<0.05). Compared to the non-septic group, higher proportion of male（21.2% vs. 8.0%，P<0.05）, higher SELDAI score（9.0 vs. 6.0，P<0.05）, higher proportion of pulsed methylprednisolone treatment within 1 month（13.5% vs. 10.7%，P<0.05）and higher dose of oral corticosteroid（20.0 vs. 15.0mg，P<0.05）can be seen in the septic group (P<0.05). About the laboratory results, lower level of platelet（129.0 vs. 194.5×10⁹/L，P<0.05）and lymphocyte（0.6 vs. 0.9×10⁹/L，P<0.05）, while higher level of serum creatine（134.0 vs. 88.0μmol/L，P<0.05）, C reactive protein（43.8 vs. 12.3mg/L，P<0.05）and erythrocyte sedimentation rate（60.0 vs. 45.5mm/h，P<0.05） can be seen in the septic group. Multivariate Logistic regression analysis revealed that male and pulse methylprednisolone treatment within 1 month were independent risk factors of sepsis in patients with lupus nephritis (P<0.05).

Conclusion

Male and pulse methylprednisolone treatment within 1 month were independently associated with sepsis in patients with lupus nephritis.