Long-term activity index after renal failure in a cohort of 32 patients with lupus nephritis.
OBJECTIVE
To characterise long-term activity levels after renal failure (RF) in lupus patients.


METHODS
A retrospective activity analysis was performed of 32 lupus nephritis (LN) patients in RF over a maximum of 34 years. Activity was recorded every 6 months using the BILAG index and serological involvement (SI) (C3 and anti-dsDNA antibodies). 'Inactive' disease was defined as no BILAG A/B and no SI, 'moderate disease' as at least BILAG 1A/ 2B or 'major' SI (C3<0.73g/L and/or anti-dsDNA>149IU/ml, and 'severe' as both BILAG 1 A/2B and major SI. Patients on dialysis (n=32) were compared to patients who had a renal transplantation (n=14).


RESULTS
In the dialysis group, 12.5% were inactive and 87.5% had at least mild-moderate activity (92.8% due to SI; 85.7% due to clinical activity) of which 37.5% demonstrated severe activity. BILAG involvement was mainly haematological (59.4%) and mucocutaneous (25%). In the renal transplantation group, 92.8% were active (100% due to SI, 84.6% due to clinical activity) of which 28.6% displayed severe activity. BILAG involvement was mainly haematological (57.1%) and renal (50%).


CONCLUSIONS
Although lupus activity is highly prevalent after RF, when a more restrictive cut off is established, activity decreases from 87.5% to 37.5% in the dialysis group and 92.8% to 28.6% in the renal transplantation group. Serological markers and haematological BILAG activity were the predominant indicators for post-RF lupus activity. We were unable to rule out whether activity derived from an intercurrent process or was intrinsic to the renal failure itself.
Internal Medicine Department, University Hospital Virgen del Rocio, Seville, Spain. cristinagpulido@gmail.com.
C
C
González-Pulido
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Croca
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Abrol
D A
DA
Isenberg
D000328:Adult; D015415:Biomarkers; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000503:physiopathology* / Q000628:therapy; D016030:Kidney Transplantation; D008181:Lupus Nephritis / Q000453:epidemiology* / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
D015415:Biomarkers