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Tromboembolismo venoso en pacientes con lupus nefritis: frecuencia y factores de riesgo - un estudio de cohorte
Fadi Kharouf1, Pankti Mehta1, Qixuan Li1
1University of Toronto Lupus Clinic, Division of Rheumatology, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada.
Rheumatology (Oxford, England)
|September 2, 2025
Resumen
El tromboembolismo venoso (TEV) afecta al 9,3% de los pacientes con lupus nefritis (LN). La mayor actividad de la enfermedad y la proteinuria son factores de riesgo clave para la TEV en pacientes con LN.
Área de la Ciencia:
- Nefrología
- Reumatología
- Medicina cardiovascular
Sus antecedentes:
- El tromboembolismo venoso (TEV) es una complicación reconocida del lupus eritematoso sistémico (LES).
- La investigación limitada de alta calidad aborda específicamente la TEV en la nefritis por lupus (LN).
Objetivo del estudio:
- Determinar la frecuencia de TEV en pacientes con diagnóstico de lupus nefritis.
- Identificar los factores de riesgo específicos que contribuyen al desarrollo de TEV en esta población de pacientes.
Principales métodos:
- Estudio de cohorte observacional prospectivo de pacientes con LN probado por biopsia (1970-2024).
- Monitoreo longitudinal de los eventos de TEV después de la aparición de EN.
- Modelos de riesgos proporcionales de Cox que varían en el tiempo utilizados para identificar los factores de riesgo, con la muerte como un riesgo concurrente.
Principales resultados:
- 324 pacientes con LN fueron seguidos durante una mediana de 9,9 años.
- La TEV se produjo en el 9,3% de los pacientes, con una mediana de tiempo hasta el primer evento de 4,4 años después de la aparición de la EN.
- Los factores de riesgo independientes para la TEV incluyen puntuaciones elevadas de SLEDAI- 2K y niveles más altos de proteinuria.
Conclusiones:
- La TEV es una complicación significativa que puede ocurrir en cualquier etapa de la nefritis por lupus.
- La actividad de la enfermedad (SLEDAI- 2K) y la proteinuria son factores de riesgo primarios para la TEV en pacientes con LN.
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