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Abstract: SA-PO0790

Profiling a Large Cohort of Patients with Lupus Nephritis Managed at a Safety-Net Hospital in Mexico City

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Cordoba Hurtado, Angela Maria, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
  • Rojas-Rivera, Jorge Enrique, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
  • Soto, Virgilia, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
  • Rovin, Brad, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
Background

There are few data on lupus nephritis (LN) from Mexico, particulary regions with limited health-care resources. Understanding local LN populations can helap to identifay the most suitable novel theraphies. We analyzed a large Hispanic LN cohort managed at the biggest public hospital in the country.

Methods

The cohort included 265 LN patients. A subset of patients representative of the entire cohort (n=155) who had no missing data were analyzed to identify factors associated with primary efficacy renal response (PERR) after 12 months of treatment. Data were analyzed using binomial logistic regression.

Results

The overall cohort was 82% female with an average age of 31 years. At baseline eGFR was 65 (23-116) ml/min and proteinuria was 3.3 (1.5-6.8) g/day. During follow up 9.1% died with 45% of deaths due to infection and 19% required renal replacement therapy. Over half the patients had class III or IV LN + class V, while 30% of patients had pure prliferative and 14% had pure class V LN. The median activity index (AI) was 10 (6-14) while chronicity indiex (CI) was 4(3-7). In the 155 patient subset (Figure) 42% achieved PERR. Compared to non-responders, responders were older (32 vs 29, p=0.052), presented less often with new onset LN (66%vs86%, p=0.004), and were more frequently treated with steroids plus mycophenolate (44% vs 24%,p=NS) than steroids plus cyclophosphamide (38% vs 56%). Responders had lower proteinuria (uPCR 2 vs 4, P=0.003), eGF >60 ml/min. (66% vs 48%, P=0.023), high-titer anti-dsDNA antibody (70% vs 54%, P=0.054), lower AI (9 vs 12, P=0.015), and higher percentage of focal glomerulosclerosis (21% vs 12%, P=0.003).

Conclusion

In Mexican individuals with LN, response rates at 12 months are consistent with reported response rates in clinical trials. Older age, recurrent LN and higher autoantibody levels were associated with better response. MMF may improve outcomes compared to cyclophosphamide, but prospective validation in needed.

Digital Object Identifier (DOI)