Impact des anticorps antiphospholipides sur l’hypertension artérielle et le devenir rénal dans la néphropathie lupique classe III/IV

Abstract : Objectives: to determine in lupus nephritis (LN) patients having an antiphospholipid syndrome (APS) but no superadded APS nephropathy, the arterial hypertension (AH) incidence and renal outcome. Methods: a retrospective monocenter study was conducted from 1999 to 2017. All patients (n=124) with a biopsy-proven LN class III/IV were included. Four superadded APS nephropathies were excluded, and 3 groups were then defined: without aPL (LN), with aPL but no clinical manifestation (LN+aPL), with APS (LN+APS). Data concerning blood pressure (BP), antihypertensive therapy (AHT), estimated glomerular filtration rate (eGFR) and end-stage renal failure (ESRF) were recorded at baseline, 1-year, 5-years and end of follow-up. Results: we retrospectively observed 78 LN (63%), 23 LN+ aPL (18.5%) and 23 LN+APS (18.5%). The mean follow-up time was 7.5 ±4.5 years for LN, 7.6 ±4.7 years for LN+aPL and 8.8 ±4.6 years for LN+APS (p=0.4). There was no difference of BP levels between the 3 groups throughout the study. At the end of follow-up, the proportion of patients without AHT was significantly lower in LN+APS (41%, 42%, and 24%, p=0.02), but eGFR, slope of eGFR and ESRF rate were similar between the 3 groups (eGFR [p=0.9], slope of eGFR [p=0.06], ESRF [p=0.5]). Conclusion: in LN patients having an APS but no superadded APS nephropathy, more AHT is required to obtain normal BP. Long term-renal outcome is good in these patients.
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Master Thesis
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Pauline Pagès. Impact des anticorps antiphospholipides sur l’hypertension artérielle et le devenir rénal dans la néphropathie lupique classe III/IV. Médecine humaine et pathologie. 2018. ⟨dumas-02091004⟩

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