Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Internal Medicine and Nephrology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Lupus. 2023 Jun;32(7):842-854. doi: 10.1177/09612033231174410. Epub 2023 May 10.
Few studies tackled the long-term effect of pregnancy on lupus nephritis (LNs); thus, the study aimed to explore the long-term impact of pregnancy on renal outcomes in Egyptian patients with LN. Group I patients included females who had their first pregnancy after LN onset with ≥5 years elapsing after delivery; group II patients included females who had never got pregnant for ≥7 years after LN onset. Data were retrospectively collected at baseline (T) and the last visit (T). The study included 43 patients in group I and 39 patients in group II. The comparisons between the two groups regarding the characteristics at T showed no significant difference regarding the serum creatinine, estimated glomerular filtration rate (eGFR), renal component of SLICC/ACR Damage Index (SDI) as well as the rate of renal flares, new-onset chronic kidney disease (CKD), progressed CKD and end-stage renal disease. Multivariate regression analysis revealed that systemic hypertension and renal flares were predictors of new-onset/progressed CKD ( = 0.019, OR [95% CI] = 4 [1.3-13]; and 0.022, 13.8 [1.5-128.8], respectively) while pregnancy was not ( = 0.363). Paired comparisons between T and T characteristics within each group revealed significant increment of serum creatinine, renal SDI and CKD prevalence; as well as decrement of eGFR in group I ( = 0.004, <0.001, 0.001 and <0.001, respectively) and group II ( = 0.006, <0.001, 0.004 and 0.002, respectively). In conclusion, pregnancy, per se, does not affect the long-term renal outcome in LN patients; however, it is rather dependent on the existence of baseline renal damage and the development of renal flares.
很少有研究探讨妊娠对狼疮肾炎（LN）的长期影响；因此，本研究旨在探讨妊娠对埃及 LN 患者肾脏结局的长期影响。第 I 组患者包括 LN 发病后至少 5 年首次妊娠的女性；第 II 组患者包括 LN 发病后至少 7 年从未怀孕的女性。数据在基线（T）和最后一次就诊（T）时进行回顾性收集。研究共纳入第 I 组 43 例和第 II 组 39 例患者。两组患者 T 时特征的比较显示，血清肌酐、估算肾小球滤过率（eGFR）、SLICC/ACR 损伤指数的肾脏成分（SDI）以及肾发作、新发慢性肾脏病（CKD）、进展性 CKD 和终末期肾病的发生率均无显著差异。多变量回归分析显示，系统性高血压和肾发作是新发/进展性 CKD 的预测因素（=0.019，OR[95%CI] = 4[1.3-13]；=0.022，13.8[1.5-128.8]），而妊娠不是（=0.363）。每组内 T 和 T 特征的配对比较显示，血清肌酐、肾脏 SDI 和 CKD 患病率显著增加；eGFR 在第 I 组（=0.004，<0.001，0.001 和<0.001）和第 II 组（=0.006，<0.001，0.004 和 0.002）中均显著下降。结论：妊娠本身不会影响 LN 患者的长期肾脏预后；然而，它更依赖于基线肾脏损伤的存在和肾发作的发生。
