Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 31:18:eAO5322.
doi: 10.31744/einstein_journal/2020AO5322. eCollection 2020.

Effect of systemic arterial hypertension and use of antiproteinuric drug in induction therapy for lupus nephritis

[Article in English, Portuguese]
Eduardo Grecco Matta  1 , Danielle Arraes Rubini  1 , Nafice Costa Araújo  1
Affiliations

Effect of systemic arterial hypertension and use of antiproteinuric drug in induction therapy for lupus nephritis

[Article in English, Portuguese]
Eduardo Grecco Matta et al. Einstein (Sao Paulo). .

Abstract
in English, Portuguese

Objective: To evaluate the therapeutic response to induction treatment in lupus nephritis patients.

Methods: A total of 29 patients diagnosed with systemic lupus erythematosus and biopsy-proven nephritis were divided into two groups, one with hypertensive individuals and another non-hypertensive patients. The hypertensive patients included were on drugs with antiproteinuric effect. The induction treatment comprised mycophenolate mofetil or cyclophosphamide, based on 24-hour proteinuria and serum creatinine parameters for therapeutic evaluation after 6 months of intervention. The retrospective evaluation of the follow-up was made based on information collected from the medical records.

Results: Patients with and without hypertension presented similar behaviors of proteinuria (p=0.127) and creatinine (p=0.514) over time. For proteinuria, only the time effect (p=0.007), but not hypertensive effect (p=0.232), was found. There was a reduction in proteinuria levels (reduction by 3.28g/24 hours, on average) from the beginning to the final measurement. As to creatinine, no hypertensive (p=0.757) or time (p=0.154) effects were found.

Conclusion: Similarity in behavior of proteinuria was observed, after induction treatment for nephritis, taking into account the hypertensive effect. The prior condition did not hinder these patients reaching the recommended proteinuria goal.

Objetivo: Avaliar resposta terapêutica a tratamento de indução de pacientes com nefrite lúpica.

Métodos: Foram divididos em dois grupos 29 pacientes com diagnóstico de lúpus eritematoso sistêmico e nefrite comprovada por biópsia, sendo um de portadores de hipertensão e outro sem essa comorbidade. Dentre os hipertensos, foram incluídos aqueles que faziam uso de antiproteinúrico. O tratamento de indução foi realizado com micofenolato de mofetila ou ciclofosfamida, sendo utilizados os parâmetros de proteinúria de 24 horas e creatinina sérica para avaliação terapêutica após 6 meses da intervenção. A avaliação retrospectiva do seguimento foi realizada a partir de informações coletadas de prontuário.

Resultados: Pacientes com e sem hipertensão apresentaram comportamentos similares de proteinúria (p=0,127) e creatinina (p=0,514) ao longo do tempo. Para a proteinúria, observou-se apenas o efeito de tempo (p=0,007), mas não de hipertensão (p=0,232). Houve redução nos níveis da proteinúria (redução de 3,28g/24 horas, em média) do início para o momento pós. Já para a creatinina, não se observou efeito de hipertensão (p=0,757) e tampouco de tempo (p=0,154).

Conclusão: Observamos similaridade no comportamento da proteinúria, após tratamento de indução para nefrite, levando em conta o efeito hipertensão. A comorbidade prévia não se mostrou impeditiva para que estes pacientes atingissem a meta de proteinúria preconizada.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: none.

Figures

Figure 1
Figure 1. Estimation of the means for creatinine in evaluation point, as per hypertension
SAH: systemic arterial hypertension.
Figure 2
Figure 2. Estimation of the means for urinary protein in evaluation point, as per systemic arterial hypertension
SAH: systemic arterial hypertension.
Figure 3
Figure 3. Proportion of proteinuria change after the intervention and respective 95% confidence interval, as per systemic arterial hypertension
SAH: systemic arterial hypertension.
Figure 4
Figure 4. Mean relative proteinuria variation and respective 95% confidence interval, as per systemic arterial hypertension
SAH: systemic arterial hypertension.
Figura 1
Figura 1. Estimativa das médias de creatinina, por momento de avaliação, segundo hipertensão arterial sistêmica
HAS: hipertensão arterial sistêmica.
Figura 2
Figura 2. Estimativa das médias de proteinúria por momento de avaliação, segundo hipertensão arterial sistêmica
HAS: hipertensão arterial sistêmica.
Figura 3
Figura 3. Proporção de alteração de proteinúria após a intervenção e respectivo intervalo de confiança de 95%, segundo hipertensão arterial sistêmica
HAS: hipertensão arterial sistêmica.
Figura 4
Figura 4. Média da variação relativa de proteinúria e respectivo intervalo de confiança de 95%, segundo hipertensão arterial sistêmica
HAS: hipertensão arterial sistêmica.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. 1. Almaani S, Meara A, Rovin BH. Update on Lupus Nephritis. Clin J Am Soc Nephrol. 2017;12(5):825-35. Review. - PMC - PubMed
    2. Almaani S, Meara A, Rovin BH. Update on Lupus Nephritis. Clin J Am Soc Nephrol. 2017;12(5):825–835. Review. - PMC - PubMed
    1. 2. Ortega LM, Schultz DR, Lenz O, Pardo V, Contreras GN. Review: Lupus nephritis: pathologic features, epidemiology and a guide to therapeutic decisions. Lupus. 2010;19(5):557-74. Review. - PubMed
    2. Ortega LM, Schultz DR, Lenz O, Pardo V, Contreras GN. Review: Lupus nephritis: pathologic features, epidemiology and a guide to therapeutic decisions. Lupus. 2010;19(5):557–574. Review. - PubMed
    1. 3. Bernatsky S, Boivin JF, Joseph L, Manzi S, Ginzler E, Gladman DD, et al. Mortality in systemic lupus erythematosus. Arthritis Rheum. 2006;54(8):2550-7. - PubMed
    2. Bernatsky S, Boivin JF, Joseph L, Manzi S, Ginzler E, Gladman DD, et al. Mortality in systemic lupus erythematosus. Arthritis Rheum. 2006;54(8):2550–2557. - PubMed
    1. 4. Klumb EM, Silva CA, Lanna CC, Sato EI, Borba EF, Brenol JC, et al. Consensus of the Brazilian Society of Rheumatology for the diagnosis, management and treatment of lupus nephritis. Rev Bras Reumatol. 2015;55(1):1-21. - PubMed
    2. Klumb EM, Silva CA, Lanna CC, Sato EI, Borba EF, Brenol JC, et al. Consensus of the Brazilian Society of Rheumatology for the diagnosis, management and treatment of lupus nephritis. Rev Bras Reumatol. 2015;55(1):1–21. - PubMed
    1. 5. Markowitz GS, D’Agati VD. Classification of lupus nephritis. Curr Opin Nephrol Hypertens. 2009;18(3):220-5. Review. - PubMed
    2. Markowitz GS, D’Agati VD. Classification of lupus nephritis. Curr Opin Nephrol Hypertens. 2009;18(3):220–225. Review. - PubMed