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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Date
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