Clinical Characteristics and Predictors of Outcome of Lupus nephritis Patients on Follow up at Two Centers in Addis Ababa, Ethiopia from August 1, 2016 up to August 30, 2020

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2020-12

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Addis Abeba University

Abstract

Background: SLE is a multisystem chronic autoimmune disease which commonly involves the kidney and is associated with high mortality and morbidity especially in populations of African descent. Objective: To describe the clinical characteristics, treatment patterns and predictors of outcome in a group of Ethiopia lupus nephritis patients from two centers. Patients and Methods: The records of 97 lupus nephritis patients on follow up from August 1, 2016 up to August 30, 2020 in two centers, Tikur Anbessa specialized hospital and a private practice center (Shebelle Higher Clinic), Addis Ababa, Ethiopia were reviewed to acquire data on clinical characteristics and outcome. All patients fulfilled 2012 SLICC criteria for SLE. Result: There were a total of 89 females and 8 male patients. Mean age at presentation of LN was 27.4 with 80(82.5%) of patients having LN as first presentation of SLE. Nephrotic range proteinuria was present in 27% and impaired kidney function was seen in 51.6% at presentation. Kidney biopsy done for 17 patients showed Class III and class IV as the commonest types. 70(74.5%) patients received immunosuppressive therapy with cyclophosphamide and MMF used in the majority. Favorable outcome was seen in 73(73.7%) after 6 months of therapy. After a median follow up of 41 months, 71.3% of patients had favorable outcome, 8(8.5%) patients had died and 1(1.1%) developed ESRD. Follow up at Tikur Anbessa specialized hospital, renal flare history and absence of response at 6 months were found to be significantly associated with unfavorable outcome. Conclusion: LN, in this study of Ethiopian patients, is mostly diagnosed concomitantly with SLE and it presents at a younger age group and with more degrees of kidney impairment, but has response to treatment comparable to most other series.

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Keywords

Systemic Lupus Erythematosus, Lupus Nephritis, Ethiopia, Africa

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