Lupus nephritis in Thailand : clinicopathologic findings and outcome in 569 patients.
The prognosis of lupus nephritis patients in Thailand has been reported to be poorer than that in Westem countries since 1978.
After a great evolution in management, we re-evaluate the long-term outcome in patients who were treated and followed up at Siriraj Hospital in Bangkok from 1984 to 1991.
Clinical and pathologic records were collected from 569 patients who were followed up for a mean period of 38.7 ± 34.6 months.
The mean age was 28 ± 10 years and the median duration of symptoms prior to admission was 7 months.
The overall probability of survival was 76.5% at 60 and 90 months after diagnosis.
Initial presence of hypertension, renal insufficiency, and World Health Organization histology class IV and III in the biopsied patients were the three independent factors significantly associated with lower survival probability.
Neither gender nor amount of proteinuria was the predictive factor for poor outcome.
During the follow-up period, 89 patients died and two patients entered a chronic dialysis program.
This study shows that the outcome of lupus nephritis in Thailand is much improved and almost equivalent to that in other countries reported since 1986.
Greater awareness and more precise diagnosis of renal abnormalities in systemic lupus erythematosus, better supportive care, including treatment of extrarenal complications, and more appropriate use of immunosuppressive drugs should all be considered as factors related to improvement in the survival rate in this study.
Mots-clés Pascal : Néphropathie, Lupus érythémateux, Disséminé, Epidémiologie, Thaïlande, Asie, Pronostic, Survie, Complication, Homme, Appareil urinaire pathologie, Rein pathologie, Peau pathologie, Tissu conjonctif pathologie, Maladie système, Maladie autoimmune, Immunopathologie
Mots-clés Pascal anglais : Nephropathy, Lupus erythematosus, Disseminated, Epidemiology, Thailand, Asia, Prognosis, Survival, Complication, Human, Urinary system disease, Renal disease, Skin disease, Connective tissue disease, Systemic disease, Autoimmune disease, Immunopathology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0542826
Code Inist : 002B14E01. Création : 01/03/1996.