Lupus Nephropathy in Mauritania: A Clinical and Longitudinal Study from the National Hospital Center of Nouakchott

毛里塔尼亚狼疮性肾病:努瓦克肖特国家医院中心的一项临床纵向研究

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Abstract

BACKGROUND AND AIM: Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus (SLE) with variable outcomes. This study aimed to describe the epidemiological, clinical, paraclinical, histopathological, and treatment outcomes of LN in the Nephrology Department of the National Hospital Center of Nouakchott. METHODS: We conducted a cross-sectional study over a 12-month period, from March 2023 to March 2024. All included patients had systemic lupus erythematosus complicated by nephropathy. We studied the epidemiological, clinical, paraclinical, histopathological, and evolutionary profile under treatment. RESULTS: Twenty-five patients were included; the mean age was 35.6 years, and the sex ratio (male/female) was 0.13. Extrarenal signs were dermatological in 12 patients and rheumatological in 10 patients. The mean proteinuria was 4.11±3.18 g/24 h (range: 0.38-14.5 g/24 h). The mean serum creatinine was 46.4±53.2 mg/L (range: 5-229 mg/L), and it was elevated in 16 patients (64%). Anti-dsDNA antibodies were positive in 16 patients, and antinuclear antibodies were positive in 13 patients. Histopathologically, classes IV and III were most frequently found in 11 and six patients, respectively; four patients had combined class IV and V, and five patients had isolated vascular and/or tubulointerstitial involvement. During the induction phase of treatment, 20 patients were on mycophenolate mofetil, while only one patient was on cyclophosphamide. Of the 22 patients with regular follow-up, three achieved complete remission, five had partial remission, nine progressed to end-stage renal disease, and five patients died. CONCLUSIONS: Lupus nephritis often presents as severe proliferative forms, with an unpredictable course and a risk of progression to chronic kidney disease and death.

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