Protéinurie et autres facteurs pronostiques d’insuffisance rénale chronique dans la néphropathie lupique de classe III/IV : étude rétrospective monocentrique sur 118 patients

Abstract : Objective: the class III/IV proliferative glomerulonephritis, according to the 2003 ISN/RPS classification, are serious forms of lupus nephritis, increasing life-threatening. If therapeutics advances during last decades have improved disease outcome, 10 to 15% of patients remain at risk to develop end-stage renal disease (ESRD). The proteinuria after induction treatment seems to be a good predictive biomarker of renal outcome. Other prognosis factors have been identified, such as response to induction treatment and renal relapses. The objective of this work was to study these different factors within the Bordeaux hospital lupus nephritis cohort. Method: a retrospective monocentric study was conducted between January 1999 and January 2018. Histologically proven class III/IV lupus nephritis were included. Results: 118 patients were included. The mean length of follow up was 8,5 years. 5% of patients evolve towards ESRD. Proteinuria at one year was a factor of good renal outcome, such as anti-dsDNA antibodies decrease, and complete remission. Non-caucasian origin, persistent proteinuria at one year, dyslipidemia, renal failure and leukocytosis at neutrophils at inclusion, were factors associated with poor renal outcome. Only the renal failure at inclusion was independently associated with poor renal outcome in multivariate analysis. Conclusion: lupus nephritis is a serious injury requiring the identification of prognosis factors in order to adapt and personalize the therapeutic options.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01975905
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Submitted on : Wednesday, January 9, 2019 - 3:57:20 PM
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Manon Roucoules. Protéinurie et autres facteurs pronostiques d’insuffisance rénale chronique dans la néphropathie lupique de classe III/IV : étude rétrospective monocentrique sur 118 patients. Médecine humaine et pathologie. 2018. ⟨dumas-01975905⟩

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