ESPN 51th Annual Meeting

ESPN 2018


 
Lupus nephritis: Long term follow-up and effect of treatment on growth
REZAN TOPALOGLU 1 NESRIN TAŞ 1 KÜBRA ÇELEGEN 1 GÜLŞAH ÖZDEMIR 1 BORA GÜLHAN 1 ALI DÜZOVA 1 FATIH ÖZALTIN 1 DICLEHAN ORHAN 2

1- HACETTEPE UNIVERSITY FACULTY OF MEDICINE, DIVISION OF PEDIATRIC NEPHROLOGY, ANKARA, TURKEY
2- HACETTEPE UNIVERSITY DEPARTMENT OF PEDIATRIC AND PERINATAL PATHOLOGY RESEARCH, ANKARA, TURKEY
 
Introduction:

 We aimed to investigate the clinical features and long-term follow-up of lupus nephritis (LN) patients in a tertiary referral center.

Material and methods:

Medical records of LN patients were investigated longitudinally.

Results:

 A total of 39 patients (30 female, 9 male) were included. Mean age of the diagnosis of LN was 13.1±3.1 year. Among patients; 9and 27 patients had neurological and  hematological system involvement at the time of LN diagnosis, respectively. Renal biopsy results revealed class 2 LN (n=8), class 3 LN (n=9), class 4 LN (n=21) and class 5 LN (n=1). Urinary proteine/creatinine was higher (p=0.028) and GFR was lower (P=0.011) in class IV LN when compared to other classes. Nearly half of the patients (n=18) had pulse methylprednisolone (MPZ)+intravenous cyclophoshamide (CYC) (n=11) or pulse MPZ+ mycophenolate mofetil (MMF) (n=7) as induction treatment. At the time of diagnosis, mean SLEDAI score was 18.8±12.3. A total of 10 patients (25.6%) experienced relapse at a mean period of 2.9±1.4 years after the diagnosis of LN. Time to first relapse is not different in patients with different gender (p=0.68), pathological classes (p=0.50) or age of diagnosis (p=0.16), induction treatment (pulse MPZ+CYC vs pulse MPZ+MMF; p=0.77). Mean duration of follow-up was 5.1±3.8 years. At the last visit; most of the patients (n=28) were in complete remission, six patients in partial remission and two patients in active disease. During follow up, three patients patients progressed to chronic kidney disease (CKD). The number of the patients with partial remission, complete remission and CKD was not different in induction treatment modalities (p=0.43). The median length SDS at last visit was -0.87 (IQR; -1.8 and -0.2). Median length SDS at the time of diagnosis and at last visit was not different (p=0.22). Median BMI SDS at last visit was higher than median SDS at diagnosis (p=0.009).

Conclusions:

 Long term follow-up showed the effectiveness of the immunosuppressive treatment. The different treatment regimes did not have any effect on height.