Introduction:
Lupus nephritis (LN) affects 60% of adults with SLE. Renal involvement significantly influences morbidity and mortality, with outcomes varying depending on the population studied.
Methods:
This ambispective study included LN patients from 2018 to 2023. We evaluated clinical and laboratory parameters, along with treatment modalities, to identify predictors of outcomes in LN.
Results:
The study included 242 patients with a mean age of 29.57±9.47 years, 87.2% female. Mean follow-up was 22.8±12.6 months. Class IV LN was most common (40.9%) followed by class V (23.6%). Hypertension predicted poor response (p=0.016). Complete remission (CR) occurred in 50.2% of cases, partial remission (PR) in 20.3%, and no response (NR) in 29.4%. Hypertension predicted a poor response (p=0.016). APLA positivity was associated with 21.7% CR, 26.1% PR, and 52.2% NR (p=0.008). CR was linked to higher eGFR, serum albumin, and lower urine protein, dsDNA, and SLEDAI scores compared to PR and NR (all p<0.001). Low C3 levels were found in 27.6% (CR), 42.6% (PR), and 59.1% (NR) (p<0.001). Higher activity and chronicity indices also predicted poor response.
Conclusions:
Hypertension, APS, elevated SLEDAI scores, higher activity and chronicity indices, hypocomplementemia, and raised dsDNA were associated with poorer outcomes. Conversely, improved hemoglobin, TLC, eGFR, and serum albumin, along with reduced 24-hour urine protein, predicted a better response.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.