OBJECTIVE: This study aims to describe the spectrum of renal manifestations and outcomes in a cohort of Filipino patients with systemic lupus erythematosus (SLE).

METHODS: Medical records of 598 Filipino patients diagnosed with SLE were retrospectively reviewed. The demographic characteristics, spectrum of renal manifestations, and outcomes were evaluated.

RESULTS: Renal involvement was recorded in 45% of Filipino patients with SLE. Various forms of renal involvement included nephritis, nephrotic syndrome, rapidly progressive glomerulonephritis, acute renal failure and chronic kidney disease. Among the patients who underwent renal biopsy, class IV or diffuse proliferative nephritis was the most common histopathologic lesion. Of the 137 patients who received at least 6 months of immunosuppressive therapy, 127 (92.7 percent) were given cyclophosphamide treatment (126 as intravenous (IV) pulse therapy), 8 (5.83 percent) received azathioprine alone while 2(1.46 percent) received mycophenolate mofetil alone. Eighty one (59.12 percent) of these patients went into clinical remission at the time of this report, 12 (8.76 percent) progressed to end stage renal disease (ESRD) or chronic kidney disease (CKD) stage 5 requiring renal replacement therapy, while the remainder were either unimproved and/or lost to follow up; 4 of these patients underwent kidney transplantation.

CONCLUSION: Renal involvement was noted in 45 percent of our cohort of Filipino patients with SLE, with nephritis as the most common manifestation, and diffuse proliferative nephritis (WHO class IV) as the most common histopathologic lesion. (Author)

Lupus Erythematosus, Systemic ; Kidney ; Nephritis