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SAT0209 (2012)
CHARACTERIZATION OF PURE MEMBRANOUS LUPUS NEPHRITIS: A COHORT OF 134 PATIENTS
L. Silva1, T. Otόn1, A. Askanase2, P. Carreira3, E. Rodríguez-Almaraz3, J. Lόpez-Longo4, I. Rúa-Figueroa5, J. Narváez6, E. Ruiz7, E. Calvo8, F. Toyos9, J.J. Alegre10, E. Tomero11, C. Montilla12, A. Zea13, E. Uriarte14, C. Marras15, V. Martínez-Taboada16, Ά. Belmonte17, J. Rosas18, E. Raya19, G. Bonilla20, M. Freire21, J. Calvo22
1H Puerta de Hierro, Madrid, Spain
2H Joint Diseases, New York, United States
3H 12 Octubre
4H Gregorio Marañόn, Madrid
5H Dr Negrín, Las Palmas
6H Bellvitge, L'Hospitalet
7H Basurto, Bilbao
8H Infanta Sofía, S Sebastián de los Reyes
9H Virgen Macarena, Sevilla
10H Dr Peset, Valencia
11H La Princesa, Madrid
12H Salamanca, Salamanca
13H Ramόn y Cajal, Madrid
14H Donostia, S Sebastián
15H Virgen Arrixaca, Murcia
16H Marqués de Valdecilla, Santander
17H Carlos Haya, Málaga
18H Marina Baixa, Villajoyosa
19H San Cecilio, Granada
20H La Paz, Madrid
21H Juan Canalejo, A Coruña
22H Sierrallana, Torrelavega, Spain

Background: Few studies and small series have addressed the characteristics of pure membranous lupus nephritis (MLN).

Objectives: To establish the clinical characteristics, treatment and prognosis of MLN and to make international and intersocial comparisons.

Methods: Twenty-one Spanish centres and 1 in the US participated in the study. All SLE patients with biopsy proven MLN were included. Data on clinical and laboratory features, prescribed drugs, renal outcomes and survival were collected. Descriptive statistics were used to describe the main features of the series. Chi-squared distribution and Fisher test were use to analyse categorical variables and the U Mann-Whitney test for quantitative variable. A p value <0.05 was considered significant.

Results: 134 patients were included (see table). Female sex (.036), a low basal serum creatinine (BSC) (0.92 Vs 1.53 mg/dl; <0.001) and previous treatment with azathioprine (AZA) (.046) were predictors of a final proteinuria <1 g. US patients (0.042), patients without a Health coverage (0.033), with previous venous thrombosis (0.037) and those who had not received chloroquine (0.011) or AZA (0.028) for MLN had less chances of achieving a final proteinuria <0.5 g. Patients with final doubled creatinine had a greater initial 24 h-proteinuria (7.73 Vs 4.37 g; 0.04) and a lower creatinine clearance (CCr) (64 Vs 109 ml/min; .032). Moreover, male sex (<0.001), basal high blood pressure (0.028), chronic cardiopathy (0.003), peripheral (0.005) or cerebral artheriopathy (.02), and not having received anticoagulant treatment were risk factors for doubling BSC. End-stage renal disease was predicted by male sex (0.009), HBP (0.019), dyslipidemia (0.002), high basal 24 h-proteinuria (8.80 Vs 4.36 g; 0.03), high BSC (2.76 Vs 0.91 mg/dl; <0.001) and a low CCr (31 Vs 108 ml/min; 0.001).

Conclusions: MLN usually begins with nephrotic syndrome, high proteinuria and normal BSC. Its prognosis is favourable in maintaining renal function although proteinuria usually persists over time. Cardiovascular disease and some socio-sanitary factors are related with bad prognosis.

Disclosure of Interest: None Declared


Citation: Annals of the Rheumatic Diseases, volume 71, supplement 3, year 2012, page 542
Session: Lupus and Sjörgren's – clinical (Poster Presentations )