Clinical an immunological factors associated with lupus nephritis in patients from northwestern Colombia / Factores clínicos y epidemiológicos asociados con nefritis lúpica en pacientes del noroccidente colombiano

ABSTRACT

A cross-sectional and multicenter study was undertaken to analyze the clinical and immunological characteristics at diagnosis associated with nephritis in northwestern Colombian patients with systemic lupus erythematosus (SLE). Thirty nine patients with lupus nephritis were included and were compared to 100 SLE patients without nephritis. A multivariate analysis was performed. The patients who developed nephritis had a higher frequency of oral ulcers (41 percent vs. 21 percent, OR3.1, 95 percent CI 1.3-7.5 p 0.01) and malar erythema (77 percent vs. 45 percent, OR4.4, 95 percent CI 1.8-10.8 p0.001). Lupus nephritis was observed in 77 percent of cases during the first year of the disease. The frequency of anti-DNA antibodies was higher in patients with nephritis, however, differences were not statistically significant (83 percent vs 64 percent, OR2.6, 95 percent CI 1.03-6.41, p0.06). The presence of other autoantibodies (anti-Ro, anti-La, anti-RNP, anti-Sm and anticardiolipin) at diagnosis was similar in both groups. This autoantibody profile remained unchanged throughout the evolution of the disease. Patients with lupus nephritis had a higher prevalence of arterial hypertension (60 percent vs 10 percent, OR13.7, 95 percent IC 5-37, 0.00001) and hyperlipidemia (30 percent vs 7 percent, OR8.1, 95 percent IC 2.5-27, p0.0006) at onset. Finally, patients with lupus nephritis required more hospitalizations (1) over the course of disease (89 percent vs 60 percent, OR7.8, 95 percent IC 2.1-29, p0.002). In conclusion, lupus nephritis appears early during the course of SLE. Malar erythema, oral ulcers, hypertension and hyperlipidemia at onset of disease are associated factors. Lupus nephritis is a major risk factor leading to repeated hospitalizations. This study may help to assist in public health policies in our population in order to improve patient outcomes while simultaneously reducing disease costs.