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Abstract: TH-PO689

Vitamin D Levels on Lupus Nephritis: Profile of a Large Brazilian Academic Center

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Kassar, Liliana M L, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
  • Freire Filho, Washington Alves, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
  • Carvalho Barros Sousa, Felipe, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
  • Strufaldi, Fernando Louzada, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
  • Silva, Karoline W C, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
  • Vieira, Ana Teresa Pereira, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
  • Dias, Cristiane B., Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
  • Yu, Luis, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
  • Jorge, Lectícia, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
Background

Lupus nephritis is present in most patients with lupus. It is believed that the imbalance between pro-inflammatory and anti-inflammatory factors is responsible for its manifestation. Vitamin D is known for its anti-inflammatory activity and plays a regulatory role in cytokine production. Therefore, we tested the association between the level of 25-OH-Vitamin D, histological class, activity index and degree of proteinuria in patients from a large Brazilian academic center.

Methods

Patients diagnosed with lupus nephritis between January 2012 and December 2018 were included. Variables evaluated were age, gender, creatinine, estimated glomerular filtration rate (eGFR) by CKD-EPI, proteinuria, histological class and serum level of 25-OH-Vitamin D at the time of kidney biopsies.

Results

253 kidney biopsies were performed during this period, 86% in women. The mean age was 31 years (13-70), creatinine 1.3 mg/dL (0.32-8.04), eGFR of 57.9 mL/min (6.2-165.3), proteinuria of 2.7g (0.07-10.7) and level of 25-OH-Vitamin-D 17 (4-48). Spearman's correlation between Vitamin D levels and proteinuria was -0.338 with p<0.001. The association between levels of vitamin D, histological class of lupus nephritis and activity index > 9 was significant (p= 0.007 and p 0.003, respectively), with the lowest median found in class IV. We didn't find associations between vitamin D levels and thrombotic microangiopathy.

Conclusion

Low levels of vitamin D were found in patients with more severe histological class, higher activity index and higher proteinuria, which may be involved as a risk factor for the inflammatory imbalance present in lupus and disease activity.