Epidemiology and Prognosis of Lupus Nephrites: A prospective coorte in a Universitary Hospital in São Paulo-SP

• Grant number: 24/20679-2
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: January 01, 2025
• End date: December 31, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Emilia Inoue Sato
• Grantee: Vinícius Cavalcanti Diniz
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Introduction: SLE is a systemic autoimmune disease of chronic evolution that predominantly affects young women. It has a multifactorial etiology and evolves in episodes of activity and remission. Renal involvement (lupus nephritis - LN) occurs in up to 50% of patients, and is more frequent in patients whose disease began in childhood. Despite the treatment currently available, morbidity and mortality are high. After 20 years, 20-30% of patients progress to end-stage renal failure, requiring dialysis or kidney transplantation, and it is one of the major causes of mortality in patients with SLE. The frequency and severity of NL varies depending on ethnicity and socioeconomic conditions. Objectives: To assess the epidemiological profile of patients with NL seen at the Autoimmune Rheumatic Diseases outpatient clinic at Hospital São Paulo/EPM-Unifesp. To evaluate: the outcome of patients with NL after five years of evolution; creatinine levels at the time of renal biopsy and evolutionarily after 5 years; frequency of comorbidities; frequency of clinical manifestations; medications used at the time of biopsy; renal outcome according to induction therapy; renal outcome according to maintenance therapy; renal outcome according to histopathological class. Population: Patients diagnosed with SLE according to the EULA/ACR 2023 classification criteria, aged over 16 years at the onset of the disease and renal biopsy performed at the nephropathology service of the Hospital do Rim (HRim) between January 2010 and January 2019. Materials and methods: Categorical variables will be presented as mean and standard deviation or median and 95%CI. Quantitative variables will be compared between groups using Student's t-test (normal distribution) or Mann-Whitney test (non-normal distribution). Normality will be analyzed using the Shapiro-Wilk test. Multivariable analysis will be carried out using multiple regression. Values of p<0.05 will be considered significant. The GraphPad Prism 8 program will be used for the statistical analysis.