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Vol. 17. Issue 6.
Pages 351-356 (June - July 2021)
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Vol. 17. Issue 6.
Pages 351-356 (June - July 2021)
Original Article
DOI: 10.1016/j.reumae.2019.09.005
Clinical and sociodemographic factors associated with lupus nephritis in Colombian patients: A cross-sectional study
Factores clínicos y sociodemográficos asociados a nefritis lúpica en pacientes colombianos: resultados de un estudio transversal
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Juan C. Díaz-Coronadoa,b, Adriana Rojas-Villarragaa,c, Deicy Hernandez-Parraa, Laura Betancur-Vásquezb,
Corresponding author
laubet-v@hotmail.com

Corresponding author.
, Jorge Lacouture-Fierrob, Daniel Gonzalez-Hurtadob, Juanita González-Arangob, Laura Uribe-Arangob, Maria C. Gaviria-Aguilarb, Ricardo A. Pineda-Tamayoa
a Grupo de Información Clínica, Artmedica IPS, Medellín, Colombia
b Departamento de Medicina Interna, Universidad CES, Medellín, Colombia
c Fundación Universitaria de Ciencias de la Salud -FUCS, Bogotá, Colombia
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Figures (1)
Tables (3)
Table 1. Characteristics of 1175 patients with systemic lupus erythematosus evaluated at a specialized center in Colombia between 2007 and 2015.
Table 2. Clinical, immunologic, sociodemographic, and exposure in lupus nephritis patients.
Table 3. Factors associated with lupus nephritis in a Colombian SLE patients.
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Abstract
Introduction

Over the past decades, incidence of SLE (Systemic Lupus Erythematosus) has increased due to early case detection and improved survival of patients. SLE presents at an earlier age and has a more severe presentation in African-American, Native American, Asian, and Hispanic populations. Worldwide, lupus nephritis (LN) is observed in 29–60% of SLE patients, it has a negative impact in renal survival and patient mortality. Several cohorts have established potential risk factors associated with lupus nephritis, such as male sex, serological markers, and some extra-renal manifestations.

Objectives

To describe sociodemographic, clinical, immunological, and environmental risk factors in Colombian SLE patients and to compare the population with and without nephritis, in order to establish risk factors and possible associations.

Materials and methods

A total of 1175 SLE patients participated in this study. During medical care, an interview and structured survey was conducted and later registered in a database. Sociodemographic, clinical, immunological, and environmental exposure variables were analyzed. Bivariate and multivariate analyses were performed using presence of LN as an outcome.

Results

Prevalence of LN was 38.7%. Variables significantly associated with LN included being male (OR 1.98), a duration of SLE>10 years (OR 1.48), positive anti-DNA (OR 1.34), positive anti-Sm (OR 1.45), and smoking (OR 1.66). Being non-smoker was a protective factor (OR 0.52).

Conclusion

This study describes potential factors associated with lupus nephritis in a Latin American population. Smoking status could be a target for intervention as it is a modifiable risk factor. The association between being male and LN is observed in Latin-American populations such as presented here. Further research in other large-scale population studies and more efforts are needed to gain better insights to explicate these relationships.

Keywords:
Systemic lupus erythematosus
Lupus nephritis
Associated factors
Latin America
Resumen
Introducción

En las últimas décadas la incidencia del Lupus eritematoso sistémico (LES) se ha incrementado debido a la detección temprana y su mejoría en la supervivencia. La nefritis lúpica (NL) se observa en el 29% a 60% de los pacientes con LES, teniendo un impacto negativo en la supervivencia renal y la mortalidad. Varias cohortes han establecido factores de riesgo asociados con la NL, como el sexo masculino, marcadores serológicos y algunas manifestaciones extrarrenales.

Objetivos

Describir los factores de riesgo sociodemográficos, clínicos, inmunológicos y ambientales en pacientes colombianos con LES y comparar la población con y sin NL para establecer posibles asociaciones.

Materiales y métodos

Se incluyeron 1175 pacientes con LES, se analizaron variables sociodemográficas, clínicas, inmunológicas y ambientales, tomadas de bases de datos de registros cínicos. Los análisis bivariados y multivariados se realizaron utilizando la presencia de NL como desenlace.

Resultados

La prevalencia de NL fue del 38,7%. Las variables significativamente asociadas con NL incluyeron sexo masculino (OR 1.98), una duración del LES>10 años (OR 1.48), anti-ADN positivo (OR 1.34), anti-Sm positivo (OR 1.45) y tabaquismo (OR 1.66), mientras que la ausencia de exposición al tabaco se comportó como factor protector (OR 0.52).

Conclusión

Se describen los factores potenciales asociados con NL en una población latinoamericana. El tabaquismo se presenta como un factor de riesgo susceptible de intervención. El sexo masculino y su asociación con NL ya ha sido reportado en otras poblaciones latinoamericanas. Se requieren investigaciones a gran escala en otras poblaciones para explicar mejor estas asociaciones.

Palabras clave:
Lupus eritematoso sistémico
Nefritis lúpica
Factores asociados
Latinoamérica

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