Publication year: 2014
Theses and dissertations in Español presented to the Universidad Nacional Mayor de San Marcos. Facultad de Medicina to obtain the academic title of Especialista. Leader: Pastor Asurza, César Augusto
Objetivo:
Determinar las correlaciones clÃnicas y el pronóstico de los hallazgos histopatológicos de la nefropatÃa del sÃndrome antifosfolÃpido (NSAF) en pacientes con nefritis lúpica. Métodos:
Se incluyó a 60 pacientes con nefritis lúpica, se analizaron las biopsias renales buscando los datos histopatológicos de NSAF, y se compararon diversas variables. Resultados:
Se encontraron hallazgos histopatológicos de NSAF en 17 pacientes (28 por ciento). Hubo mayor prevalencia de hipertensión en pacientes con NSAF (p=0.03). Además se encontró mayor Ãndice de actividad (p=0.03), Ãndice de cronicidad (p=0.0007), fibrosis intersticial (p=0.0017) y atrofio tubular (p=0.0031) en este grupo. Los hallazgos de NSAF se asociaron de manera significativa con hipertensión (p=0.03) e insuficiencia renal (OR 3.36, 95 por ciento IC 1.01-11.18, p=0.04); y de manera altamente significativa con fibrosis intersticial (p=0.0006) y atrofia tubular (OR 16.76, 95 por ciento IC 2.04-137.83, P=0.0012). Conclusión:
Los hallazgos histopatológicos de NSAF son un factor de riesgo de insuficiencia renal y atrofia tubular, además se asocian con hipertensión y fibrosis intersticial; todos indicadores de mal pronóstico renal. Por esto, los hallazgos de NSAF deben ser buscados en las biopsias renales de pacientes lúpicos.
Objective:
Determinate the clinic correlations and the outcome of histopathology findings of antiphospholipid syndrome nephropathy (APSN) in lupus nephritis patients. Methods:
This study was undertaken in 60 lupus nephritis patients. The renal biopsies were examined looking for APSN. Some features were compared between patients with and without APSN. Results:
The histopathology findings of APSN were found in 17 (28 per cent) patients. There was a higher prevalence of hypertension in APSN patients (p=0.03). The activity and chronicity indices were al so significantly higher in this group (p=0.03 and p=0.0007 respectively): and a higher prevalence of interstitial fibrosis (p=0.0017) and tubular atrophy (p=0.0031) was found in APSN patients. Also, APSN was associated with hypertension (p=0.03) and renal failure (OR 3.36, 95 per cent IC 1.01-11.18, p=0.04); and highly associated with interstitial fibrosis (p=0.0006) and tubular atrophy (OR 16.76, 95 per cent IC 2.04-137.83, p=0.0012). Conclusions:
The histopathology findings of APSN are risk factors of renal failure and tubular atrophy; and they are associated with hypertension and interstitial fibrosis; all of them are poor renal prognostic indicators. For that, APSN must be looking for in renal biopsies of lupus patients.