Clinical renal involvement in Afro-Caribbean lupus patients.
This study reports the severity of clinical lupus nephritis (LN), defined as the sustained presence of proteinuria and/or cellular casts, in a group of 68 newly diagnosed patients with systemic lupus erythematosus (SLE) in Curaçao. Fifty-four patients (78%) developed clinical signs of LN, of whom 31 (54%) had clinical LN at the time of SLE diagnosis. The probability of developing clinical LN reached 80% in the first 3 years after SLE diagnosis and hardly increased later. No clinical or serological differences existed at the time of SLE diagnosis or at onset of LN between patients with early-or late-onset LN. Survival in patients without LN was 100% at 5 years, while for patients with clinical LN these rates at 1 and 5 years were 91% and 59%, respectively (P = 0.0001); male LN patients had a worse prognosis than females (P = 0.012), while time of LN onset did not influence survival. Six patients (11%) developed end-stage renal failure; all were female, five had early LN and one had late-onset LN (P = 0.17). Renal survival was 97% and 80% at 1 and 5 years, with decreased rates for patients with nephrotic-range proteinuria (P = 0.02). Hypertension was present in 13% of LN patients, but had no influence on patient or renal survival. Thus, clinical LN was a frequent complication, which carried a poor prognosis in these Afro-Caribbean lupus patients.
Nossent
J C
JC
St Elisabeth Hospital, Department of Internal Medicine, Willemstad, Curaçao, Netherland Antilles.
D000328:Adult; D044383:Black People; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008181:Lupus Nephritis / Q000208:ethnology* / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D015996:Survival Rate; D014900:West Indies