Lupus nephritis in Latin American patients: 10-year results from a single medical center in Argentina.
Lupus
; 25(2): 217-22, 2016 Feb.
Article
em En
| MEDLINE
| ID: mdl-26296360
ABSTRACT
INTRODUCTION:
Several studies have shown that Hispanic patients generally experience a worse renal prognosis than non-Hispanic white patients with lupus. To date, there is no report on American College of Rheumatology (ACR) renal response criteria (ACR-RRC) in patients from Latin America.OBJECTIVE:
To evaluate treatment response in patients with proliferative and membranous lupus nephritis (LN) according to ACR-RRC.METHODS:
A retrospective study (2001-2011) was performed in our hospital and the data collected included clinical information, renal assessment and immunological parameters. Details related to treatment received during induction and maintenance therapy were also recorded.RESULTS:
The study included forty-three Latin American patients (37 women) from Argentina. Mean follow-up was 54 months. The regimen used for induction therapy included intravenous cyclophosphamide (IV-CYC) for six months in 36 patients and only seven received mycophenolate mofetil (MMF) given twice daily for a total dose of 2.5 ± 0.5 grams a day. For the maintenance period, six patients continued with quarterly IV-CYC, 20 patients received MMF (1.5 ± 0.5 grams a day) and 17 patients received azathioprine (AZA) 1.5 - 2 mg/kg/day. ACR-RRC observed after induction therapy was complete response in 19%, partial response in 9%, improvement in 42%, unchanged in 14%, and 16% had deterioration despite treatment. ACR-RRC observed after maintenance therapy was complete response in 30%, partial response in 23%, improvement in 19%, unchanged in 16%, and 12% had deterioration. Relapse was observed in 11 patients (25%). Ten out of 11 cases (91%) who relapsed did not achieve a complete response at the end of the induction therapy.CONCLUSION:
In Latin American patients from Argentina, only 19% could achieve a complete response after induction therapy and 30% achieved a complete response after maintenance therapy. Failing to obtain a complete response after induction therapy was related to an increased risk of relapse during long-term follow-up in our study.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Nefrite Lúpica
Tipo de estudo:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do sul
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Argentina
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article