title: Predictive risk factors for failure to induction therapy of lupus nephritis in a cohort of Colombian patients.
abstract: OBJECTIVE
  To determine the predictors of failure to obtain remission after induction therapy for proliferative lupus nephritis in a group of northwestern Colombian patients.
  
  
  METHODS
  A retrospective study was conducted. We included patients with systemic lupus erythematosus according to the American College of Rheumatology criteria who had nephritis confirmed by renal biopsy.
  
  
  RESULTS
  We followed 84 patients: 88.1% female, and 11.9% male. The mean age at diagnosis of systemic lupus erythematosus was 27.5±11.8 years (9-70). The average time between diagnosis of systemic lupus erythematosus and proliferative nephritis onset was 13.6 months (0-168). Histopathologic type: iv (78.57%), iii (15.47%), iii-iv/v (5.96%). Activity index: 6.7±4.6. Chronicity index: 2±2.7. 24-hour proteinuria (mg): 6,164 (130-18,100). Baseline creatinine: 1.14 mg/dL (0.43-7.4). Induction therapy: Steroids (100%), cyclophosphamide (76.2%) and mycophenolate mofetil (23.8%). At six months, 56% of individuals failed to achieve partial or complete remission. Predictors of failure to induction therapy were, in accordance with the bivariate analysis (OR; 95%CI): creatinine level more than 1.2mg/dL (10.8; 3.18-36.84; P<.005), nephrotic range proteinuria (11.9; 3.09-45.8; P<.001), and an activity index above 8 (5.04; 1.7-14.3; P<.001). In the multivariate analysis, only baseline creatinine higher than 1.2mg/dL (10.92; 2.65-45.02; P=.001), and nephrotic range proteinuria (9.81; 1.85-52.04; P=.007) were significant.
  
  
  CONCLUSIONS
  A significant percentage of Colombian patients fail to achieve remission of proliferative lupus nephritis after six months of treatment.
authors.affiliation: Médico Internista Reumatólogo, Grupo de Reumatología, Hospital Pablo Tobón Uribe, Medellín, Colombia.
authors.forename: Luis Fernando
authors.initials: LF
authors.lastname: Pinto Peñaranda
authors.affiliation: Estudiante de Maestría Epidemiología, Universidad CES, Medellín, Colombia.
authors.forename: Inis Lizeth
authors.initials: IL
authors.lastname: Castro Mercado
authors.affiliation: Estudiante de Maestría Epidemiología, Universidad CES, Medellín, Colombia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Duque Caballero
authors.affiliation: Profesor Asociado, Facultad de Medicina, Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana, Medellín, Colombia.
authors.forename: Javier Darío
authors.initials: JD
authors.lastname: Márquez Hernández
authors.affiliation: Médico Internista Reumatólogo, Grupo de Reumatología, Hospital Pablo Tobón Uribe, Medellín, Colombia; Estudiante de Maestría Epidemiología, Universidad CES, Medellín, Colombia. Electronic address: carjaivel@hotmail.com.
authors.forename: Carlos Jaime
authors.initials: CJ
authors.lastname: Velásquez Franco
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003105:Colombia; D005260:Female; D006801:Humans; D008181:Lupus Nephritis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure; D055815:Young Adult
keywords: Inducción de remisión; Lupus nephritis; Nefritis lúpica; Nephrotic syndrome; Remission induction; Síndrome nefrótico