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Childhood lupus nephritis: 12 years of experience from a developing country's perspective

Moumita Samanta1, Madhumita Nandi1, Rakesh Mondal2

  • 1Department of Pediatrics, NRS Medical College, Kolkata, India.

European Journal of Rheumatology
|November 23, 2017
PubMed

Insights

Long-term outcomes for pediatric lupus nephritis in India show over half achieved remission, but 17.39% mortality occurred, often from sepsis in end-stage renal disease.

Area of Science:

  • Pediatric Nephrology
  • Autoimmune Diseases
  • Systemic Lupus Erythematosus

Background:

  • Systemic lupus erythematosus (SLE) frequently affects children, with lupus nephritis being a common and serious complication.
  • Understanding long-term outcomes in pediatric lupus nephritis is crucial for improving patient management, particularly in developing countries.

Purpose of the Study:

  • To evaluate the long-term clinical course and outcomes of lupus nephritis in children diagnosed with SLE.
  • To identify factors influencing mortality and disease progression in this pediatric cohort.

Main Methods:

  • A retrospective observational study was conducted over 12 years at a tertiary care hospital in Eastern India.
  • Data from 46 children with lupus nephritis were analyzed for clinicopathological presentation, treatment, and outcomes.
  • Kaplan-Meier analysis and log-rank tests were used to compare mortality rates across different lupus nephritis classes and therapies.

Main Results:

  • Lupus nephritis occurred in 58.97% of pediatric SLE patients, with a mean age of presentation at 10.2 years.
  • Class IV lupus nephritis was most common (30.43%), followed by Class II (26.91%).
  • Over 12 years, 52.17% achieved complete remission, 17.39% died (sepsis with end-stage renal disease being the leading cause), and 5 developed end-stage renal disease (ESRD).

Conclusions:

  • Pediatric lupus nephritis in India has a significant long-term impact, with a substantial proportion achieving remission but also facing considerable mortality.
  • No significant differences in mortality were found between lupus nephritis classes or treatment groups, highlighting the need for further research into risk factors and interventions.
Abstract

Keywords:
Childhood lupus nephritisdeveloping countryend-stage renal diseaseoutcome

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