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Related Concept Videos

Disorders of the Urinary System01:20

Disorders of the Urinary System

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The urinary system is responsible for eliminating waste and excess fluids from the body. However, disorders of the urinary system can arise due to various reasons like infections, stress, age, congenital abnormalities, and lifestyle.
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Urinary Tract Infection in Systemic Lupus Erythematosus: Report from A Developing Country.

M A K Azad1, M N Islam, M R Choudhury

  • 1Dr Mohammad Abul Kalam Azad, Assistant Professor, Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh;

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PubMed
Summary
This summary is machine-generated.

Urinary tract infections (UTIs) are common in Systemic Lupus Erythematosus (SLE) patients, with E. coli being the most frequent pathogen. Lupus nephritis and cyclophosphamide use are significant risk factors for UTIs in SLE.

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Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Nephrology

Background:

  • Urinary tract infections (UTIs) are a significant cause of morbidity and mortality in patients with Systemic Lupus Erythematosus (SLE).
  • Understanding the frequency, causative organisms, and risk factors for UTIs in SLE is crucial for patient management.
  • Previous studies have indicated a higher susceptibility to infections in SLE patients, but specific data on UTI in this population requires further investigation.

Purpose of the Study:

  • To determine the frequency of urinary tract infections (UTIs) in patients diagnosed with Systemic Lupus Erythematosus (SLE).
  • To identify the common microorganisms responsible for UTIs in this patient cohort.
  • To investigate potential risk factors associated with the development of UTIs in SLE patients.

Main Methods:

  • An observational study was conducted involving 169 consecutive SLE patients at a rheumatology lupus clinic.
  • Patients with urinary symptoms were assessed, and data on demographics, disease activity (SLEDAI), organ damage (SLICC/ACR), and medication use (steroids, HCQ, MMF, azathioprine, cyclophosphamide) were collected.
  • Laboratory investigations included serum markers (C3, C4, CRP, ANA, anti-ds DNA, CBC) and urine analysis with culture and sensitivity testing.

Main Results:

  • Out of 169 enrolled patients, 150 completed the study, with 40 patients diagnosed with UTIs, resulting in a UTI rate of 28.57%.
  • Escherichia coli (E. coli) was the most frequently identified organism, accounting for 52.5% of UTI cases.
  • Bi-variate analysis identified high disease activity (SLEDAI), severe organ damage (SLICC score), lupus nephritis, and cyclophosphamide use as risk factors. Multivariate analysis confirmed cyclophosphamide as a significant independent risk factor.

Conclusions:

  • The frequency of UTIs in Systemic Lupus Erythematosus (SLE) patients is notably high.
  • Past history of lupus nephritis and the use of cyclophosphamide are identified as significant risk factors for developing UTIs in SLE.
  • These findings highlight the importance of monitoring and preventive strategies for UTIs in SLE patients, particularly those with lupus nephritis or on immunosuppressive therapy like cyclophosphamide.