Kidney Week

Abstract: TH-PO643

Antiproteinuric Effect and Transient Reduction in Kidney Function of Calcineurin Inhibitors in Hispanic Patients with Lupus Nephritis

Session Information

• Lupus Nephritis: Clinical, Outcomes, and Therapeutics
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Ramirez, Irving Gaston, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico

Irving Gaston Ramirez, MD

• Alamilla-Sanchez, Mario, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico

Mario Alamilla-Sanchez, MD, MSc

• Yanez Salguero, Valeria, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico

Valeria Yanez Salguero, MD

• Morales Lopez, Enrique Fleuvier, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico

Enrique Fleuvier Morales Lopez

• Yama Estrella, Martin Benjamin, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico

Martin Benjamin Yama Estrella, MD

• Gonzalez-Fuentes, Carolina, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico

Carolina Gonzalez-Fuentes, MD, MSc

• Hopf, Karen, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico

Karen Hopf, MD

• Ruiz Rivera, Fani Guadalupe, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico

Fani Guadalupe Ruiz Rivera, PhD

• Diaz Garcia, Juan Daniel, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico

Juan Daniel Diaz Garcia, MD

Background

Systemic lupus erythematosus is an autoimmune disease with common renal involvement. Although current remission inital therapies are effective, a high portion of patients suffer flares or are treatment resistant. Combining immunosuppressants with ICNs may improve clinical response, but scarce data exists for the Hispanic population.

Methods

Patients with SLE and (LN) with persistent proteinuria despite previous immunosuppression and who began a combined regimen, including CNI, were included. 24-hour proteinuria and eGFR by CKD-EPI were assess at 6 and 12 months.

Results

239 records from patients with LN diagnosis were evaluated, and 42 met inclusion criteria. At 6 months, 40% of the patients obtained complete (CR), and partial response (PR) was reached by 26% of patients. At 12 months, CR and PR were reached by 44% and 32% of patients respectively. A notable reduction in proteinuria was seen at 6 and 12 months compared to baseline (2.89 vs 1.21 g/d, p < 0.001; vs 0.78 g/d, p< 0.001). A transient reduction in eGFR was detected at 6 months (109 vs 104 ml/min/1.73 m², p= 0.005), which improved significantly at 12 months (109 vs 117 ml/min/1.73 m², p=0.002).

Conclusion

In Hispanic patients with lupus nephritis who previously used immunosuppressor regimes with partial or no response, the addition of a calcineurin inhibitor can be effective. It attains optimal biochemical response rates despite a brief reduction in eGFR that improves without treatment withdrawal.