Lupus nephritis (LN) in combination with impaired renal function, defined by an estimated glomerular filtration rate (eGFR) <70 mL/min/1.73 m2, is strongly associated with the presence of atherosclerosis in patients with systemic lupus erythematosus (SLE), according to the results of a cross-sectional study published in Rheumatology (Oxford).
The investigators sought to explore the association among LN, renal function, and atherosclerosis by assessing coronary artery calcium (CAC) and carotid plaque in patients with SLE. The presence of carotid plaque and CAC was measured in a total of 147 patients with SLE, both with LN (n=74) and without LN (n=73). The participants were divided into 4 groups based on LN and renal function: SLE without LN and eGFR ≥70 mL/min/1.73 m2 (n=58); SLE without LN and eGFR <70 mL/min/1.73 m2 (n=15); SLE with LN and eGFR ≥70 mL/min/1.73 m2 (n=52); and SLE with LN and eGFR <70 mL/min/1.73 m2 (n=22).
The median patient age was 46 years; 89% of the participants were women, and the median eGFR was 89 mL/min/1.73 m2. CAC score >0 was reported in 39% of participants and carotid plaque was present in 20%. The presence of carotid plaque and/or CAC was highest among patients with SLE and impaired renal function. Regression analyses demonstrated that compared with patients with SLE without LN and eGFR ≥70 mL/min/1.73 m2, only the combination of LN and impaired renal function was significantly associated with the presence of CAC (odds ratio [OR], 6.82; 95% CI, 1.59-29.00; P =.01) and carotid plaque (OR, 5.60; 95% CI, 1.19-26.00; P =.03).
The investigators concluded that the combined presence of LN and impaired renal function, with an eGFR <70 mL/min/1.73 m2, is strongly linked to the presence of atherosclerosis in individuals with SLE. Results highlight the importance of preserving renal function in patients with SLE and LN to attenuate the development of atherosclerosis.
Hermansen ML, Sandholt B, Fuchs A et al. Atherosclerosis and renal disease involvement in patients with systemic lupus erythematosus: a cross-sectional cohort study [published online July 16, 2018]. Rheumatology (Oxford). doi: 10.1093/rheumatology/key201.