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Abstract: FR-PO642

Characteristics and Outcomes of a Lupus Nephritis Cohort From Latin America

Session Information

Category: Glomerular Diseases

  • 1303 Glomerular Diseases: Clinical‚ Outcomes‚ and Trials

Authors

  • Zavala Miranda, María Fernanda, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Pérez Arias, Abril A., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Macedo, Sofia E. Márquez, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Morales-Buenrostro, Luis E., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Comunidad Bonilla, Roque Armando, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Mejia-Vilet, Juan M., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
Background

Differences in Lupus nephritis (LN) presentation, prognosis, and rates of progression to end-stage renal disease (ESRD) have been described among patients from different genetic backgrounds, ethnicities, and geographic regions. Our aim was to characterize the clinical presentation and outcomes of a Hispanic population from Latin America.

Methods

We studied 441 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 analyzed by survival analysis and included the response to therapy, renal relapses, progression of kidney disease (decline in eGFR≥30%, doubling of serum creatinine, ESRD), 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 81mL/min/1.73m2 (IQR 48-118), and 24h-uPCR was 3.4g/g (IQR 1.9-5.6). Mixed class LN (III/IV+V) was the most frequent. Over a median follow-up of 79 months, complete response rates were 22.3%, 41.7%, and 51.7%, at 6-, 12-, and 24-months, respectively. Renal relapse rates were 32.2% and 50.6% at 3- and 5-years. By 3- and 5-years, 20.9% and 31.5% had decline in eGFR ≥30%, 13.8% and 22.8% doubled their serum creatinine, and 8.6% and 17.7% progressed to ESRD. The factors associated with adverse kidney outcomes were age, eGFR at presentation, the histologic chronicity index, and the response to therapy. Patient survival was 98.2% and 97.1% at 3- and 5-years.

Conclusion

The response to treatment and patient survival in our cohort is comparable to that observed in other regions, there is a high rate of renal relapses and progression to ESRD.

Rates of progression to loss of kidney function by response status at different months of follow up.