Predictive Risk Factors for Failure to Induction Therapy of Lupus Nephritis in a Cohort of Colombian Patients
| Autor: | Carlos Jaime Velásquez Franco, Inis Lizeth Castro Mercado, Luis Fernando Pinto Peñaranda, Javier Darío Márquez Hernández, Vladimir Duque Caballero |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Cyclophosphamide Lupus nephritis Colombia Gastroenterology Young Adult chemistry.chemical_compound Risk Factors Internal medicine medicine Humans Treatment Failure Child Aged Retrospective Studies Creatinine Lupus erythematosus business.industry Remission Induction Retrospective cohort study General Medicine Middle Aged medicine.disease Lupus Nephritis Rheumatology chemistry Immunology Female business Nephritis Nephrotic syndrome medicine.drug |
| Zdroj: | Reumatología Clínica (English Edition). 10:147-151 |
| ISSN: | 2173-5743 |
| DOI: | 10.1016/j.reumae.2013.12.011 |
| Popis: | a b s t r a c t Objectives: To determine the predictors of failure to obtain remission after induction therapy for prolife- rative lupus nephritis in a group of northwestern Colombian patients. Material and methods: A retrospective study was conducted. We included patients with systemic lupus erythematosus according to the American College of Rheumatology criteria who had nephritis confirmed by renal biopsy. Results: We followed 84 patients: 88.1% female, and 11.9% male. The mean age at diagnosis of sys- temic lupus erythematosus was 27.5±11.8 years (9-70). The average time between diagnosis of systemic lupus erythematosus and proliferative nephritis onset was 13.6 months (0-168). Histopathologic type: IV (78.57%), III (15.47%), III-IV/V (5.96%). Activity index: 6.7±4.6. Chronicity index: 2±2.7. 24-hour protein- uria (mg): 6164 (130-18,100). Baseline creatinine: 1.14 mg/dL (0.43-7.4). Induction therapy: Steroids (100%), cyclophosphamide (76.2%) and mycophenolate mofetil (23.8%). At six months, 56% of individuals failed to achieve partial or complete remission. Predictors of failure to induction therapy were, in accor- dance with the bivariate analysis (OR; 95% CI): creatinine level more than 1.2 mg/dL (10.8; 3.18-36.84; P < .005), nephrotic range proteinuria (11.9; 3.09-45.8; P < .001), and an activity index above 8 (5.04; 1.7-14.3; P < .001). In the multivariate analysis, only baseline creatinine higher than 1.2 mg/dL (10.92; 2.65-45.02; P = .001), and nephrotic range proteinuria (9.81; 1.85-52.04; P = .007) were significant. Conclusions: A significant percentage of Colombian patients fail to achieve remission of proliferative lupus nephritis after six months of treatment. © 2013 Elsevier Espana, S.L. All rights reserved. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect