'Sestre Milosrdnice University Hospital Center (KBC Sestre milosrdnice)'
Doi
Abstract
Lupus nephritis (LN) is one of the most severe features of systemic lupus erythematosus
(SLE). Data on LN is scarce in the Croatian population. We analysed the characteristics of
LN patients diagnosed at our tertiary referral centre. In this retrospective study, we analysed the following
features of patients with biopsy-proven LN diagnosed between 2011 and 2020: demographics,
renal laboratory parameters, renal histopathology, and treatment.
A total of 38 patients were included (30 females; mean age 39±15 years). The most common indication
for kidney biopsy was proteinuria (89%). The proportion of LN classes was: class I (2.6%), II
(5.3%), III (18.4%), IV (42.1%), V (13.2%), III+V (10.5%), IV+V (5.3%). The median time from SLE
diagnosis to histologic confirmation of LN was 1.0 year. All patients were treated with methylprednisolone
(MP), 68% received MP pulses. Induction treatment included intravenous (IV) cyclophosphamide
(CYC) (71%) (15 patients treated per Euro-Lupus and 9 per the National Institutes of
Health regimen), oral CYC (3%), or mycophenolate mofetil (11%). 79% of patients received antimalarials.
While there is heterogeneity between different populations, our patient profile was similar to
that from other European studies. Further follow-up of this group is necessary to assess outcomes in
our population.Lupusni nefritis (LN) je česta i vrlo ozbiljna manifestacija sustavnog eritemskog lupusa (SLE). Još uvijek nema dovoljno
podataka o karakteristikama bolesnika s LN u Hrvatskoj. Analizirali smo karakteristike bolesnika s LN koji su liječeni u
referentnom centru naše tercijarne ustanove. U ovu retrospektivnu studiju uključili smo bolesnike s biopsijom potvrđenim
LN u periodu od 2011. do 2020. godine, analizirali smo demografske podatke, parametre bubrežne funkcije, patohistološki
nalaz bioptata bubrega i liječenje. U studiju je uključeno 38 bolesnika (30 žena, prosječna dob 39±15godina). Najčešća indikacija
za biopsiju bubrega bila je proteinurija (89%). Raspodjela klasa LN bila je sljedeća: klasa I(2,6 %), II(5,3 %), III(18,4 %),
IV(42,1 %), V(13,2 %), III+V(10,5 %), IV+V(5,3 %). Prosječno vrijeme od dijagnoze SLE do histološke potvrde LN bilo je
1,0 godina. Svi bolesnici su liječeni kortikosteroidima, 68 % liječeno je bolusima metilprednizolona. Indukcijska terapija
uključivala je parenteralnu primjenu ciklofosfamida (CYC) (71 %) (15 bolesnika liječeno je prema Euro-lupus protokolu, 9
bolesnika prema protokolu Nacionalnog instituta za zdravlje (NIH)), peroralni CYC (3 %) ili mikofenolat mofetil (11 %).
Antimalarike je primilo 79 % bolesnika. Unatoč heterogenosti između različitih populacija s LN, profil bolesnika uključen u
ovu studiju sličan je ostalim europskim studijama. Daljnje praćenje potrebno je da bi se istražili ishodi u ovoj populaciji
