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P96 Prognostic factors for chronic kidney disease in patients with class V lupus nephritis in 4 reference centers in Mexico
  1. Ivette Ruiz-Leija1,
  2. David Herrera-Van Oostdam2,
  3. Jaime Borjas1,
  4. Enrique Faugier3,
  5. Sandra Rodríguez-Aguayo3,
  6. Tayde Gracia-Aréchiga4,
  7. Miguel Saavedra-Salinas4,
  8. Fedra Irazoque5,
  9. Lilia Andrade5,
  10. Carlos Abud-Mendoza2,
  11. Grupo de Estudio Potosino de Nefritis Lúpica (LUNPOS)2
  1. 1Dept. of Nephrology, Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosí, Mexico
  2. 2Dept. of Rheumatology, Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosí, Mexico
  3. 3Dept. of Rheumatology, Hospital Infantil de Mexico ‘Federico Gómez’, Mexico City, Mexico
  4. 4Dept. of Rheumatology, Centro Médico Nacional ‘La Raza’ IMSS, Mexico City, Mexico
  5. 5Dept. of Rheumatology, Centro Médico Nacional ‘20 de Noviembre’ ISSSTE, Mexico City, Mexico

Abstract

Objective Analyze prognostic factors for chronic kidney disease progression in Mexican patients with class V lupus nephritis (LN), comparing them with mixed classes.

Methods Retrospective cohort, 74 patients 12–80 years old from 4 different hospitals: 33% LN class V, 23% LN class III+V and 43.2% LN class IV+V.

Results Sixty-two females (83.7%), mean age 33 years old (12–63), 59.5% had hypertension, 6.8% had type 2 diabetes and 8.1% had antiphospholipid antibody syndrome. Twelve-month follow-up eGFR <60 mL/min/1.73m2 was similar among classes III+V and IV+V LN 40.8% vs class V LN 40%. Even with higher initial eGFR (61 vs 105 mL/min/1.73m2 p=0.017) and despite adequate treatment, eGFR at 12 months follow-up in class V patients remained the same proportion (56 vs 96 mL/min/1.73m2 p= 0.105). The percentage of patients with class III+V and IV+V vs class V with eGFR <60 mL/min/1.73m2 at 12-month follow-up was similar: 40.8% vs 40% (p=0.946). eGFR <60 mL/min/1.73m2 decline was seen in 55.1% of classes III+V and IV+V group and in 40% of class V group. There was no significant difference in factors for baseline proteinuria at 3, 6, 12, or 24 months in both groups, although those with higher levels of proteinuria had lower eGFR (p=0.0009) (table 1). Most patients received mycophenolic acid (92%), azathioprine (12%), and other immunosuppressive drugs, including tacrolimus (36%) and/or cyclophosphamide (56%). As for other medications, 56% received ACE inhibitors, 40% ARA2, 88% hydroxychloroquine and 80% statins. Only two thirds with class V LN had complete remission (64% vs 40.8% p=0.059), partial remission 12%, relapse 20% and no response 24%. Forty percent of patients had eGFR deterioration < 60 mL/min/1.73m2 at 12 or more months (table 1).

Conclusion Mexican patients with class V LN present with greater deterioration of renal function, frequently with arterial hypertension (60%). eGFR either maintains or worsens at 12 or more months of follow-up, even with adequate/intensive treatment, compared to what is reported in the literature.

View this table:
Abstract P96 Table 1
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/lupus-2024-el.150

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