Anatomoclinical Aspects and Progression of Lupus Nephritis in African Patients
Published on: 2019-03-11
Introduction: Renal damage is one of the most severe manifestations of systemic lupus erythematosus, and affects 40-60% of patients. We conducted this study to evaluate the epidemiological, clinical, paraclinical and progression aspects of lupus nephritis in African patients. Patients and Method: this was a retrospective and descriptive study, conducted over a 10-year period from January 1, 2007 to December 31, 2016, in the nephrology department of Aristide Le Dantec Hospital. Patients with lupus nephritis were included. The studied parameters were epidemiological, clinical, paraclinical and progression. Results: In a total of 93 black patients with lupus, there were 64 cases of lupus nephritis, a prevalence of 69%. The mean age of the patients was 31.97 ± 10.44 years old. There were 81% women and 19% men, a sex ratio of 0.23. Hypertension was found in 34.3% of patients. Renal failure was present in 34.5% of patients. Nephrotic syndrome was found in 71.90% of cases. Class III was found in 24 (37.5%) patients, class IV in 20 (31.25%) patients, class V in 15 (23.4%) patients, class II in 4 (6.25%) patients and class I in 1 (1.6%) patients. The combination of corticosteroids and immunosuppressants was used in 56.25% of cases. After a follow-up of 6 months, 38.8% of the patients were in complete remission, 42.8% of the patients were resistant and 10.2% of the patients were in end-stage renal disease. The death was observed in 5 patients and the causes were pulmonary embolism, bacterial meningitis and pulmonary tuberculosis and indeterminate in 2 patients. Conclusion: the proliferative classes were the most frequent. The risk of progression to chronic renal failure was relatively high. The death was related to thromboembolic and infectious complications.