Incidencia de pacientes con lupus eritematoso que desarrollan nefritis lúpica estudio a realizar en el Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón en el período del 2013- 2014
Fecha
2015
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
Resumen
Introducción: La Nefritis Lúpica (NL) complicación más frecuente y seria, causa más importante de morbi-mortalidad en estos pacientes. La presentación varía desde una proteinuria subnefrótica asintomática hasta una glomerulonefritis rápidamente progresiva, con ERC, considerándose un factor predictivo de mal pronóstico.
Objetivo: Analizar la incidencia de NL, para determinar si es muy frecuente en nuestro medio y hacer el seguimiento adecuado logrando un diagnóstico oportuno y prevención de la enfermedad. Conocer el sexo, grupo etario afectado, parámetros clínicos y comorbilidades frecuentes en el grupo de estudio.
Pacientes y métodos: Estudio de observación indirecta, descriptivo-retrospectivo. Se incluyó pacientes atendidos en las diversas áreas del Hospital Dr. Abel Gilbert Pontón con diagnóstico de LES, periodo 2013-2014
Resultados: De 193 pacientes con LES, 106 (57%) desarrollaron NL, de los cuales 88% son sexo femenino y 12% masculino, donde el 12% al momento del diagnóstico tenían 15-24 años; 34% entre 25-34; 11% entre 55-64s. Hallazgos clínicos la proteinuria 90%, hematuria microscópica 72%, síndrome Nefrótico 64%, el 46% con disminución del filtrado glomerular (TG), cilindros 38%, HTA 21%. Las comorbilidades osteoporosis 34% Síndrome antifosfolipídico 28% DM II 16%, Neoplasias 6% e hipotiroidismo 4%.
Conclusiones: la NL se presenta en más de la mitad de pacientes con LES, el sexo femenino es predominantemente afectado, edad al momento del diagnóstico se estima entre los 25-34. La proteinuria presente en casi todos los casos, el síndrome nefrótico, la hematuria microscópica y la disminución del FG son habituales y la HTA es poco común. Comorbilidades frecuentes: Osteoporosis y Síndrome Antifosfolipídico.
Introduction: Lupus Nephritis (NL) more frequent and serious complication leading cause of morbidity and mortality in these patients. The presentation varies from asymptomatic proteinuria subnephrotic to a rapidly progressive glomerulonephritis, ERC, considered a predictor of poor prognosis. Objective: To analyze the incidence of NL, to determine if it is very common in our environment and make the appropriate follow-achieving early diagnosis and prevention of disease. Know the sex, age group affected, clinical parameters and frequent comorbidities in the study group. Patients and methods: The study of indirect observation, descriptive and retrospective. Patients seen in various areas of the Hospital Dr. Abel Gilbert Ponton diagnosed with SLE 2013-2014 period included. Results: Of 193 patients with SLE, 106 (57%) developed NL, of which 88% are female and 12% male, where 12% at diagnosis were 15-24; 34% 25-34; 11% among 55-64s. Clinical findings proteinuria 90%, 72% microscopic hematuria, nephrotic syndrome 64%, 46% with decreased glomerular filtration rate (TG), cylinders 38%, hypertension 21%. The comorbidities: osteoporosis 34% antiphospholipid syndrome 28% DM II 16%, Neoplasms 6% and 4% hypothyroidism. Conclusions: NL occurs in more than half of patients with SLE, the female is predominantly affected, age at diagnosis is estimated between 25-34. This in most cases proteinuria, nephrotic syndrome, microscopic hematuria and decreased GFR are common and hypertension is rare. Frequent comorbidities: Osteoporosis and antiphospholipid syndrome.
Introduction: Lupus Nephritis (NL) more frequent and serious complication leading cause of morbidity and mortality in these patients. The presentation varies from asymptomatic proteinuria subnephrotic to a rapidly progressive glomerulonephritis, ERC, considered a predictor of poor prognosis. Objective: To analyze the incidence of NL, to determine if it is very common in our environment and make the appropriate follow-achieving early diagnosis and prevention of disease. Know the sex, age group affected, clinical parameters and frequent comorbidities in the study group. Patients and methods: The study of indirect observation, descriptive and retrospective. Patients seen in various areas of the Hospital Dr. Abel Gilbert Ponton diagnosed with SLE 2013-2014 period included. Results: Of 193 patients with SLE, 106 (57%) developed NL, of which 88% are female and 12% male, where 12% at diagnosis were 15-24; 34% 25-34; 11% among 55-64s. Clinical findings proteinuria 90%, 72% microscopic hematuria, nephrotic syndrome 64%, 46% with decreased glomerular filtration rate (TG), cylinders 38%, hypertension 21%. The comorbidities: osteoporosis 34% antiphospholipid syndrome 28% DM II 16%, Neoplasms 6% and 4% hypothyroidism. Conclusions: NL occurs in more than half of patients with SLE, the female is predominantly affected, age at diagnosis is estimated between 25-34. This in most cases proteinuria, nephrotic syndrome, microscopic hematuria and decreased GFR are common and hypertension is rare. Frequent comorbidities: Osteoporosis and antiphospholipid syndrome.
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Lupus eritematoso, Nefritis lúpica, Indicadores de morbimortalidad, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador