Curso clínico de la nefropatía membranosa lúpica pura / Long-Term outcome of type V lupus membranous glomerulonephritis
Rev. méd. Chile
;
133(1): 23-32, ene. 2005. ilus, tab
Article
Dans Espagnol
| LILACS
| ID: lil-398013
ABSTRACT
Background:
The long-term outcome of the pure form of WHO type V lupus membranous glomerulonephritis is apparently more benign than that of other forms of lupus glomerulonephritis. However 12percent of such patients progress to terminal renal failure. The presence of proteinuria may be an indication of cytotoxic agents.Aim:
To study the clinical long-term outcome of WHO type V lupus membranous glomerulonephritis. Material andmethods:
A retrospective analysis of all kidney biopsies of a University Pathology Department, with the diagnosis of WHO type V lupus membranous glomerulonephritis. Review of medical records of patients with the disease and one clinical assessment of all living patients.Results:
Between 1973 and 2000, 703 kidney biopsies were done to patients with systemic lupus erythematosus. Of these, 40 were membranous glomerulonephritis and in 33 patients (28 women, age range 6-71 years), data on the evolution and survival was obtained. Nineteen had type Va and the rest type Vb nephritis. Two presented with renal failure and 11 with proteinuria over 3.5 g/24h. The median follow-up since the renal biopsy was 63 months (range 1-316). At the end of follow-up, four had a creatinine clearance of less then 15 ml/h and four a clearance between 15 and 29 ml/h (one of these received a renal allograft). Eleven (33percent) patients had died, mostly due to infections. Life expectancy at five years with a creatinine clearance over 15 ml/h was 75percent. Bad prognostic factors were an elevated creatinine clearance over 15 ml/h was 75percent. Bad prognostic factors were an elevated creatinine and high blood pressure at the moment of the biopsy.Conclusions:
The clinical outcome of these patients was bad. Twelve percent reached a stage of terminal renal failure. This is in contrast with the 3percent progression to a similar stage of proliferative glomerulonephritis treated with i.v. cyclophosphamide. New therapies for this condition must be sought.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Glomérulonéphrite lupique
/
Glomérulonéphrite extra-membraneuse
Type d'étude:
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Adolescent
/
Adulte
/
Enfant
/
Femelle
/
Humains
/
Mâle
Pays comme sujet:
Amérique du Sud
/
Chili
langue:
Espagnol
Texte intégral:
Rev. méd. Chile
Thème du journal:
Médicament
Année:
2005
Type:
Article
Pays d'affiliation:
Chili
Institution/Pays d'affiliation:
Pontificia Universidad Católica de Chile/CL
/
Servicio de Salud Metropolitano Oriente/CL
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