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Revista Virtual de la Sociedad Paraguaya de Medicina Interna
versión On-line ISSN 2312-3893
Resumen
MARTINEZ, Lis Faviola Rondelli et al. Predictive factors of clinical evolution in hospitalized patients with lupus nephritis. Rev. virtual Soc. Parag. Med. Int. [online]. 2022, vol.9, n.2, pp.94-103. ISSN 2312-3893. https://doi.org/10.18004/rvspmi/2312-3893/2022.09.02.94.
ABSTRACT
Introduction:
Lupus nephritis is a frequent complication in patients diagnosed with systemic lupus erythematosus, especially at an early age.
Objective:
To determine predictive factors that intervene in the clinical evolution of hospitalized patients with lupus nephritis.
Methodology:
Observational, retrospective, cross-sectional study with an analytical component. Men and women, older than 18 years, with a diagnosis of lupus nephritis, who attended the Hospital Nacional of Itauguá, Paraguay, in the period 2018-2021, were included. Patients with incomplete medical records were excluded. The research was approved by the Ethics Committee of the National University of Itapúa.
Results:
Eighty-two patients with a recent or known diagnosis of lupus nephritis were studied, with a mean age of 31 ± 11 years (range 16-75 years), 68 patients were female and 46 of them had primary school. The average disease activity, measured by SLEDAI-2K, was 16±6 (range 4 - 32), and at the time of hospitalization 49 classified as severe activity. On admission, the mean creatinine value was 3.22±3.33 mg/mL, proteinuria 1820±2177 mg/day, C3 58±35 mg/dL and C4 11±9 mg/dL. Mortality occurred in 18 patients (22%). The most frequent causes of death were infections. The predictors of mortality were the evolution of the disease greater than 4 years and proteinuria in the nephrotic range (p <0.05).
Conclusions:
The predictors of mortality in patients with lupus nephritis were proteinuria in the nephrotic range and disease time of less than 4 years of evolution.
Palabras clave : systemic lupus erythematosus; lupus nephritis; mortality.