Lupus Nephritis in Pediatric Practice: 20-Year Experience in Care
https://doi.org/10.21508/1027-4065-2020-65-6-108-115
Abstract
Purpose of the Study: assessment of the course and outcomes of the lupus nephritis in children; determination of the efficiency of use of the angiotensin-converting enzyme inhibitors for the lupus nephritis.
Children Characteristics and Study Methods. Over a 20-year period, we analyzed the data of 36 children with the systemic lupus erythematosus and lupus nephritis at the ages from 5 to 17 years.
Results. In 72.2% of the cases, the kidney damage was noted at the disease onset, and the severe, recurrent course of the lupus nephritis was registered. The nephrotic syndrome has developed in 47.2% of cases. All patients received the comprehensive treatment: corticosteroids, cyclophosphamide, azathioprine, selective immunosuppressants. A study was conducted for 23 children to determine the efficiency of the enalapril treatment prescribed for the purpose of the nephroprotection. It was revealed that this drug improves the long-term results. There was registered the twofold decrease in the disease recurrence rate, fivefold decrease in the level of daily proteinuria. Five-year survival rate was observed in 100% of the patients, 10-year – in 91.6%, end-stage renal failure was diagnosed in 8.4% of the children. 5 patients died in adult life (mortality rate is 13.9%).
Conclusion. The children with the lupus nephritis require the continuation maintenance therapy. The use of the selective immunosuppressants and nephroprotectors has contributed to the renal survival.
About the Authors
G. A. Makovetskaya
Samara State Medical University
Russian Federation
Samara
Russian Federation
Samara
L. I. Mazur
Samara State Medical University
Russian Federation
Samara
Russian Federation
Samara
O. V. Borisova
Samara State Medical University
Russian Federation
Samara
Russian Federation
Samara
V. N. Barinov
Samara Regional Clinical Hospital named after V.D. Seredavin
Russian Federation
Samara
Russian Federation
Samara
O. A. Sedashkina
Samara Regional Clinical Hospital named after V.D. Seredavin
Russian Federation
Samara
Russian Federation
Samara
E. A. Barannikova
Samara Regional Clinical Hospital named after V.D. Seredavin
Russian Federation
Samara
Russian Federation
Samara
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For citations:
Makovetskaya G.A., Mazur L.I., Borisova O.V., Barinov V.N., Sedashkina O.A., Barannikova E.A. Lupus Nephritis in Pediatric Practice: 20-Year Experience in Care. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2020;65(6):108-115. (In Russ.) https://doi.org/10.21508/1027-4065-2020-65-6-108-115
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