CKD tied to morbidity, mortality in patients with SLE

Patients with systemic lupus erythematosus (SLE), including those without prior lupus nephritis (LN), are vulnerable to the development of chronic kidney disease (CKD), suggests a recent study. Furthermore, CKD may increase the risk of morbidity and mortality.

A total of 175 adult patients with SLE were included in this single-centre, retrospective, medical records review study, conducted between 2014 and 2023, with a mean follow-up of 18.3 years. The authors performed statistical analyses using chi-square tests, t tests, multivariate regression, and Cox proportional hazards models.

CKD was characterized by estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² or albuminuria ≥30 mg/24 h in ≥2 consecutive tests, spaced ≥3 months apart.

Of the patients, 12 required kidney replacement therapy. Eight-nine out of 163 patients (54.6 percent) had a CKD diagnosis, including 15.7 percent with reduced eGFR only, 52.8 percent with albuminuria only, and 31.5 percent with both.

LN significantly correlated with a higher risk of CKD (hazard ratio, 5.4). Less than half of the patients with CKD (46.1 percent) had an LN history. CKD also correlated with greater cardiovascular morbidity and hospitalization rates for SLE exacerbations and infections.

In Cox analyses, LF was found to be strongly predictive of CKD. Other predictors included age and lower eGFR at diagnosis. Furthermore, CKD was significantly associated with mortality among patients with SLE, as shown in both univariate and multivariate analyses (19.1 percent vs 1.4 percent; p<0.001).

“This study emphasizes the clinical relevance of CKD diagnosis and management in patients with SLE,” the authors said.