Persistent hypertension in lupus nephritis and the associated risk factors

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Abstract

Arterial hypertension (HPT) burden up to two third of systemic lupus erythematosus (SLE) patients and contributes to accelerated atherosclerosis and cardiovascular (CV) risk. We aim to determine the prevalence of HPTamong lupus nephritis (LN) patients who were in complete remission (CR) for a minimum of 6 months, with estimated glomerular filtration rate (eGFR) of >60 mL/min/1.73 m<sup>2</sup>. This is a cross-sectional study of 64 LN patients who attended Nephrology/ SLE Clinic at The National University of Malaysia Medical Centre (UKMMC). Persistent hypertension (blood pressure (BP) ≥140/90 mmHg for at least two occasions), CR for a minimum of 6 months and eGFR of >60 mL/min/1.73 m<sup>2</sup> were identified. Univariate and multivariate analyses were performed to determine the demographic and disease characteristics associated with HPT. Thirty-four of them (53.1%) were hypertensive. Persistent HPT was associated with disease duration, acute kidney injury and high BP at the onset of LN, longer duration interval to achieve CR, number of relapses and cyclosporine A (CyA) use. There were no associations between histological classes, nephrotic range proteinuria, body mass index and waist circumference with HPT. Factors independently associated with HPT were disease duration OR 1.06 [95%CI (0.91–1.24)], longer duration interval to achieve CR OR 1.104 [95%CI (1.02–1.19)], number of relapses OR 2.53 [95% CI (1.01–6.3)] and CyA use OR 5.3 [95% CI (1.14–23.9)]. The prevalence of HPT among LN is high despite in remission. Aggressive treatment is important to achieve early CR and to prevent relapses.

Original languageEnglish
Article numberA093
Pages (from-to)93-97
Number of pages5
JournalClinical Rheumatology
Volume34
Issue number1
DOIs
Publication statusPublished - 2015

Fingerprint

Lupus Nephritis
Hypertension
Glomerular Filtration Rate
Recurrence
Systemic Lupus Erythematosus
Cyclosporine
Nephrology
Malaysia
Waist Circumference
Proteinuria
Acute Kidney Injury
Atherosclerosis
Body Mass Index
Multivariate Analysis
Cross-Sectional Studies
Demography
Blood Pressure

Keywords

  • Cyclosporine A
  • Hypertension
  • Lupus nephritis
  • Remission
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology
  • Medicine(all)

Cite this

@article{a8a1e716eec14750871d2c1b1d2e50fc,
title = "Persistent hypertension in lupus nephritis and the associated risk factors",
abstract = "Arterial hypertension (HPT) burden up to two third of systemic lupus erythematosus (SLE) patients and contributes to accelerated atherosclerosis and cardiovascular (CV) risk. We aim to determine the prevalence of HPTamong lupus nephritis (LN) patients who were in complete remission (CR) for a minimum of 6 months, with estimated glomerular filtration rate (eGFR) of >60 mL/min/1.73 m2. This is a cross-sectional study of 64 LN patients who attended Nephrology/ SLE Clinic at The National University of Malaysia Medical Centre (UKMMC). Persistent hypertension (blood pressure (BP) ≥140/90 mmHg for at least two occasions), CR for a minimum of 6 months and eGFR of >60 mL/min/1.73 m2 were identified. Univariate and multivariate analyses were performed to determine the demographic and disease characteristics associated with HPT. Thirty-four of them (53.1{\%}) were hypertensive. Persistent HPT was associated with disease duration, acute kidney injury and high BP at the onset of LN, longer duration interval to achieve CR, number of relapses and cyclosporine A (CyA) use. There were no associations between histological classes, nephrotic range proteinuria, body mass index and waist circumference with HPT. Factors independently associated with HPT were disease duration OR 1.06 [95{\%}CI (0.91–1.24)], longer duration interval to achieve CR OR 1.104 [95{\%}CI (1.02–1.19)], number of relapses OR 2.53 [95{\%} CI (1.01–6.3)] and CyA use OR 5.3 [95{\%} CI (1.14–23.9)]. The prevalence of HPT among LN is high despite in remission. Aggressive treatment is important to achieve early CR and to prevent relapses.",
keywords = "Cyclosporine A, Hypertension, Lupus nephritis, Remission, Systemic lupus erythematosus",
author = "Shaharir, {Syahrul Sazliyana} and Ruslinda Mustafar and Rozita Mohd and {Mohamed Said}, {Mohd Shahrir} and {Abdul Gafor}, {Abdul Halim}",
year = "2015",
doi = "10.1007/s10067-014-2802-0",
language = "English",
volume = "34",
pages = "93--97",
journal = "Clinical Rheumatology",
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T1 - Persistent hypertension in lupus nephritis and the associated risk factors

AU - Shaharir, Syahrul Sazliyana

AU - Mustafar, Ruslinda

AU - Mohd, Rozita

AU - Mohamed Said, Mohd Shahrir

AU - Abdul Gafor, Abdul Halim

PY - 2015

Y1 - 2015

N2 - Arterial hypertension (HPT) burden up to two third of systemic lupus erythematosus (SLE) patients and contributes to accelerated atherosclerosis and cardiovascular (CV) risk. We aim to determine the prevalence of HPTamong lupus nephritis (LN) patients who were in complete remission (CR) for a minimum of 6 months, with estimated glomerular filtration rate (eGFR) of >60 mL/min/1.73 m2. This is a cross-sectional study of 64 LN patients who attended Nephrology/ SLE Clinic at The National University of Malaysia Medical Centre (UKMMC). Persistent hypertension (blood pressure (BP) ≥140/90 mmHg for at least two occasions), CR for a minimum of 6 months and eGFR of >60 mL/min/1.73 m2 were identified. Univariate and multivariate analyses were performed to determine the demographic and disease characteristics associated with HPT. Thirty-four of them (53.1%) were hypertensive. Persistent HPT was associated with disease duration, acute kidney injury and high BP at the onset of LN, longer duration interval to achieve CR, number of relapses and cyclosporine A (CyA) use. There were no associations between histological classes, nephrotic range proteinuria, body mass index and waist circumference with HPT. Factors independently associated with HPT were disease duration OR 1.06 [95%CI (0.91–1.24)], longer duration interval to achieve CR OR 1.104 [95%CI (1.02–1.19)], number of relapses OR 2.53 [95% CI (1.01–6.3)] and CyA use OR 5.3 [95% CI (1.14–23.9)]. The prevalence of HPT among LN is high despite in remission. Aggressive treatment is important to achieve early CR and to prevent relapses.

AB - Arterial hypertension (HPT) burden up to two third of systemic lupus erythematosus (SLE) patients and contributes to accelerated atherosclerosis and cardiovascular (CV) risk. We aim to determine the prevalence of HPTamong lupus nephritis (LN) patients who were in complete remission (CR) for a minimum of 6 months, with estimated glomerular filtration rate (eGFR) of >60 mL/min/1.73 m2. This is a cross-sectional study of 64 LN patients who attended Nephrology/ SLE Clinic at The National University of Malaysia Medical Centre (UKMMC). Persistent hypertension (blood pressure (BP) ≥140/90 mmHg for at least two occasions), CR for a minimum of 6 months and eGFR of >60 mL/min/1.73 m2 were identified. Univariate and multivariate analyses were performed to determine the demographic and disease characteristics associated with HPT. Thirty-four of them (53.1%) were hypertensive. Persistent HPT was associated with disease duration, acute kidney injury and high BP at the onset of LN, longer duration interval to achieve CR, number of relapses and cyclosporine A (CyA) use. There were no associations between histological classes, nephrotic range proteinuria, body mass index and waist circumference with HPT. Factors independently associated with HPT were disease duration OR 1.06 [95%CI (0.91–1.24)], longer duration interval to achieve CR OR 1.104 [95%CI (1.02–1.19)], number of relapses OR 2.53 [95% CI (1.01–6.3)] and CyA use OR 5.3 [95% CI (1.14–23.9)]. The prevalence of HPT among LN is high despite in remission. Aggressive treatment is important to achieve early CR and to prevent relapses.

KW - Cyclosporine A

KW - Hypertension

KW - Lupus nephritis

KW - Remission

KW - Systemic lupus erythematosus

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U2 - 10.1007/s10067-014-2802-0

DO - 10.1007/s10067-014-2802-0

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