ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 651

Predictors of Renal Damage in Systemic Lupus Erythematosus Patients from Latin America

Cristina Reátegui-Sokolova1, Manuel Ugarte-Gil 2, Guillermina B Harvey 3, Guillermo Pons-Estel 4, Rosana Quintana 5, Luis Catoggio 6, Enrique Soriano 7, Mercedes Garcia 8, Veronica Saurit 9, Francisco Caeiro 10, Eloisa Bonfa 11, Nílzio da Silva 12, Emilia Sato 13, Gloria Vasquez 14, Loreto Massardo 15, Oscar Neira 16, Mario Cardiel 17, Ignacio Garcia De-La Torre 18, Mary-Carmen Amigo 19, Marlene Guibert-Toledano 20, Margarita Portela-Hernandez 21, Rosa Chacon-Diaz 22, Graciela Alarcón 23 and Bernardo A. Pons-Estel 24, 1Hospital Guillermo Almenara Irigoyen. EsSalud, Lima, Peru, 2Universidad Científica del Sur, Lima, Peru, 3GLADEL, Rosario, Argentina, 4Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina, 5Centro Regional de Enfermedades Autoinmunes y Reumáticas (CREAR), Grupo Oroño,Rosario, Rosario, Argentina, 6Rheumatology Section, Internal Medicine Service, Hospital Italiano de Buenos Aires, Argentina., Ciudad Autonoma de Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina, 7Rheumatology Section, Internal Medicine Service, Hospital Italiano de Buenos Aires, Argentina., Buenos Aires, Buenos Aires, Argentina, 8Hospital San Martín, La Plata, Argentina, 9Hospital Privado, Centro Médico de Córdoba, Córdoba, Argentina, Cordoba, Argentina, 10Hospital Privado de Córdoba, Cordoba, Argentina, 11Rheumatology Division, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Sao Paulo, Brazil., Sao Paulo, Sao Paulo, Brazil, 12Universidade Federal de Goiás, Goiânia, Goias, Brazil, 13Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil., San Pablo, Brazil, 14University of Antioquia, Medellin, Antioquia, Colombia, 15Centro de Biología Celular y Biomedicina, Facultad de Medicina y Ciencia. Universidad San Sebastián, Santiago, Chile., Santiago, Chile, 16Sección Reumatología, Hospital del Salvador. Universidad de Chile. Unidad de Reumatología. Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo., Santiago, Chile, Santiago, Chile, 17Centro de Investigación Clínica de Morelia, SC, Morelia, México., Morelia, Mexico, 18Departamento de Inmunología y Reumatología,Htal General de Occidente y Universidad de Guadalajara.Mexico, Guadalajara, Mexico, 19Servicio de Reumatología, Centro Médico ABC, Ciudad de México, México., Mexico, Mexico, 20GLADEL, La Habbana, Cuba, 21Departamento de Reumatología, Hospital de Especialidades CMN SXXI, IMSS, Ciudad de México, Mexico, Mexico, ME, 22Servicio de Reumatología, Policlínica Méndez Gimón, Caracas, Venezuela., Caracas, Venezuela, 23University of Alabama at Birmingham, Birmingham, 24Centro Regional de Enfermedades Autoinmunes y Reumáticas (CREAR), Grupo Oroño, Rosario, Rosario, Argentina

Meeting: 2019 ACR/ARP Annual Meeting

Keywords:

Session Information

Date: Sunday, November 10, 2019

Title: SLE – Clinical Poster I: Epidemiology & Pathogenesis

Session Type: Poster Session (Sunday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Lupus nephritis and renal damage are serious complications in patients with SLE. Proteinuria < 0.8 g/24 hours at 12 months has proven to be a good predictor of long-term renal outcome. The aim of this study is to identify the predictors of renal damage in Latin American SLE patients.

Methods: Patients with lupus nephritis from a multiethnic, multinational, multicenter cohort were included in this study. Lupus nephritis was defined clinically (proteinuria greater than 0.5 g/day on two or more occasions or the presence of red cell casts) or histologically (renal biopsy compatible with lupus nephritis histopathology class II-V according to the World Health Organization). The following time-dependent variables were considered as possible predictors of renal damage: proteinuria, low complement, anti-dsDNA, red cell casts, creatinine level, hypertension, the renal component of the SLEDAI, prednisone dose, immunosuppressive drugs use, and antimalarial use. The following baseline variables were also included: gender, age at nephritis diagnosis, residence rural or urban, ethnic group and socioeconomic status (SES). Proteinuria was assessed at baseline and after 12 months, to determine if early response (proteinuria < 0.8 g/d within 12 months since the diagnosis of lupus nephritis) is protective of renal damage occurrence in SLE patients; renal damage was defined as an increase of at least one point in the renal domain of the SLICC/ACR damage index. Univariable and multivariable Cox regression models using a backward selection method with alpha-level to stay in the model set at 0.05 were performed.

Results: Four hundred and ninety patients were included; 89.4% of them (n = 438) were female, with a median age at SLE diagnosis of 26.4 IQR (19.0-36.0) years and median age at nephritis diagnosis of 27.5 (20.3-37.4) with a median follow-up after nephritis diagnosis of 3.9 (2.0-5.6) years. At baseline, the median creatinine was 0.9 (0.7-1.1) mg/dl. One-hundred and twenty patients (24.5%) accrued renal damage during their follow-up.

Early response to treatment (as defined) (HR 0.604), and antimalarial use (HR 0.477) were protective of the occurrence of renal damage whereas male gender (HR 1.930), low socioeconomic status (HR 3.945), hypertension (HR 1.854) and the renal component of the SLEDAI (HR 1.768) were risk factors for renal damage occurrence. Univariable and multivariable models are depicted in table 1.

Conclusion: Early response and antimalarial use were protective of renal damage occurrence, while male gender, hypertension, low socioeconomic status, higher renal domain of SLEDAI were risk factors for its occurrence in SLE patients. Strict control of modifiable risk factors such as early proteinuria response, antimalarial use and hypertension control, is therefore strongly recommended for patients with lupus nephritis to minimize damage.


Table ACR

Disclosure: C. Reátegui-Sokolova, None; M. Ugarte-Gil, None; G. Harvey, None; G. Pons-Estel, None; R. Quintana, None; L. Catoggio, None; E. Soriano, Abbvie, 2, 5, 8, ABBVIE, 2, 5, 8, AbbVie, 2, 5, 8, Amber, 8, Amgen, 5, 8, AMGEN, 5, 8, BMS, 8, BRISTOL, 8, Bristol MS, 8, BRISTOL MYERS SQUIBB, 8, Bristol-Myers Squibb, 8, eli lilly, 5, 8, Genzyme, 8, GENZYME, 8, GLAXO, 2, Glaxo, 2, glaxosmithkline, 2, GlaxoSmithKline, 2, GSK, 2, Janssen, 8, Lilly, 5, 8, LILLY, 5, 8, Novartis, 2, 5, 8, NOVARTIS, 2, 5, 8, PFIZER, 5, 8, Pfizer, 5, 8, Pfizer Inc, 5, 8, Roche, 2, 8, ROCHE, 2, 8, Sandoz, 5, SANDOZ, 5, Sanofi, 5, SANOFI, 5, SANOPHY, 5, UCB, 8; M. Garcia, None; V. Saurit, None; F. Caeiro, None; E. Bonfa, Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq #305068/2014-8), 2, Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP #2015/03756-4 and #2010/10749-0), 2; N. da Silva, None; E. Sato, None; G. Vasquez, None; L. Massardo, None; O. Neira, None; M. Cardiel, None; I. Garcia De-La Torre, None; M. Amigo, None; M. Guibert-Toledano, None; M. Portela-Hernandez, None; R. Chacon-Diaz, None; G. Alarcón, None; B. Pons-Estel, None.

To cite this abstract in AMA style:

Reátegui-Sokolova C, Ugarte-Gil M, Harvey G, Pons-Estel G, Quintana R, Catoggio L, Soriano E, Garcia M, Saurit V, Caeiro F, Bonfa E, da Silva N, Sato E, Vasquez G, Massardo L, Neira O, Cardiel M, Garcia De-La Torre I, Amigo M, Guibert-Toledano M, Portela-Hernandez M, Chacon-Diaz R, Alarcón G, Pons-Estel B. Predictors of Renal Damage in Systemic Lupus Erythematosus Patients from Latin America [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/predictors-of-renal-damage-in-systemic-lupus-erythematosus-patients-from-latin-america/. Accessed .

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