Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 # 63-C-69, Bogota, Colombia.
Clin Rev Allergy Immunol. 2011 Jun;40(3):199-207. doi: 10.1007/s12016-010-8249-4.
Lupus nephritis (LN) is one of the most serious complications of systemic lupus erythematosus (SLE) since it is the major predictor of poor prognosis. The purpose of this study was to examine the clinical and immunological characteristics associated with LN development during the course of SLE in Colombians. Therefore, patients with SLE followed at five different referral centers in Medellin, Bogota, and Cali were included in this cross-sectional and multicenter study. Factors influencing LN were assessed by conditional logistic regression analysis, adjusting by gender, age at onset, duration of disease, and city of origin. The entire sample population included 467 patients, of whom 51% presented with LN. The presence of anti-dsDNA antibodies (adjusted odds ratio (AOR), 2.06; 95% confidence interval (CI), 1.16-3.65), pleuritis (AOR, 3.82; 95% CI, 1.38-10.54), and hypertension (AOR, 2.63; 95% CI, 1.23-5.62) were positively associated with LN, whereas the presence of anti-La antibodies was a protective factor against LN development (AOR, 0.4; 95% CI, 0.19-0.85). A review of literature on LN in different populations is made. The identified clinical- and laboratory-associated factors would assist earlier diagnosis and guide decisions on therapeutic interventions on this critical and frequent complication of SLE.
狼疮性肾炎(LN)是系统性红斑狼疮(SLE)最严重的并发症之一,因为它是预后不良的主要预测因素。本研究的目的是研究与哥伦比亚 SLE 患者 LN 发展相关的临床和免疫学特征。因此,这项横断面和多中心研究纳入了在麦德林、波哥大、卡利的五个不同转诊中心随访的 SLE 患者。通过条件逻辑回归分析评估影响 LN 的因素,调整性别、发病年龄、疾病持续时间和原籍城市。整个样本人群包括 467 名患者,其中 51%患有 LN。抗 dsDNA 抗体的存在(调整优势比(AOR),2.06;95%置信区间(CI),1.16-3.65)、胸膜炎(AOR,3.82;95%CI,1.38-10.54)和高血压(AOR,2.63;95%CI,1.23-5.62)与 LN 呈正相关,而抗 La 抗体的存在是 LN 发展的保护因素(AOR,0.4;95%CI,0.19-0.85)。对不同人群的 LN 文献进行了回顾。确定的临床和实验室相关因素将有助于早期诊断,并指导 SLE 这一关键和常见并发症的治疗干预决策。