Search

Background: Lupus nephritis (LN) is a common and serious manifestation of SLE, occurring in more than half of patients with SLE during their course of illness, in 10–25% of such patients, kidney disorder progresses to end-stage renal disease (ESRD). Objective: To determine the predictors of remission in patients with biopsy-proven lupus nephritis, and to assess the long-term renal remission rate in our lupus nephritis patients. Patients and Methods: This is a retrospective observational study carried out at the Rheumatology and Nephrology Units, Internal Medicine Department, Menoufia and Mansoura Universities Hospitals, Egypt for a 1-year duration between 1 June 2019 and 1 June 2020. A total of 60 patients with biopsy-proven LN were studied. Results: In the current study, after six months of follow-up, about two-thirds of patients achieved remission. The urinary protein creatinine ratio (UPCR) of 4.9 g/g, systemic lupus erythematosus disease activity index (SLEDAI) of 20 and Hb of 8.8 g/dl at the third month are valuable for predicting remission at the sixth month in active lupus nephritis. On multivariate analysis, serum creatinine (SCr) at the time of diagnosis is the only independent predictor of remission (complete or partial) at 6 months. According to the receiver operating characteristic curve, the cut-off value of SCr ≤ 2.9 mg/dL with 100% specificity and 98 % sensitivity was a predictor for renal remission. Conclusion: The UPCR of 4.9 g/g, SLEDAI of 20 and Hb of 8.8 g/dl at the third month are valuable for predicting remission at the sixth month in active lupus nephritis. Serum creatinine level ≤2.9 mg/dL at the time of diagnosis was the only independent predictor of complete remission at 6 months. [ABSTRACT FROM AUTHOR]

Background: Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease characterized by having varying clinical presentation, severity, unpredictable course as well as outcomes. Recent disease-modifying conventional and biologic agents have enhanced rates of attaining both short- and long-term management goals, including minimization of glucocorticoid dose and use. This study was carried out to develop an up-to-date evidence-based, consensus on clinical practice guidelines for treat-to-target management of systemic lupus erythematosus in adults. Results: The response rate to the online questionnaires, sent to the expert panel who participated in the three rounds, was 95.5%. At the end of round 3, a total of 14 recommendation sections were proposed for the T2T management of patients with SLE. Agreement with the recommendations (rank 7–9) ranged from 90.9–100%. Consensus was reached (i.e., ≥ 80% of respondents strongly agreed or agreed) on the proposed statements. Conclusion: These recommendations provide a consensus on the treat-to-target management of patients with SLE. They provide strategies to reach optimal outcomes in common clinical scenarios, based on a combination of evidence and expert opinion. [ABSTRACT FROM AUTHOR]

Purpose: This research aimed to evaluate Quality of life (QoL) in Egyptian children with idiopathic Nephrotic syndrome (INS) in comparison to healthy children and children with chronic non-renal illnesses. Methods: In this questionnaire-based study, 300 children were included, 100 with INS and 2 matched control groups: healthy group, and chronic non-renal illness group. QoL was assessed using the Pediatric Quality of Life Inventory (PedsQL™ 4.0 Generic Core Scales) and the Generic Children's QoL Measure (GCQ). Results: All mean scores of PedsQL domains in INS group were significantly higher than chronic non-renal illness group and significantly lower than the healthy control group (p = < 0.001) for all and similar results reported also regarding GCQ scores in INS compared to diseased (p = 0.02) and healthy controls (p = 0.006). Steroid-resistant NS group had lowest scores in all domains (p = < 0.001) compared to other clinical phenotypes of NS group. The long duration of illness, higher number of relapses, high cumulative steroid dose, and high number of medications used were associated with lower PedsQL and GCQ scores (p < 0.001 for all) Conclusion: This is the first study to asses QoL in Egyptian children with INS and correlates QoL scores to clinical phenotypes and complications of the disease. Egyptian children with INS need strenuous efforts from pediatricians and psychiatrists to improve QoL. Both PedsQL™ 4.0 scale and GCQ are simple, convenient, and can be used in daily clinical practice to asses QoL in children with NS. [ABSTRACT FROM AUTHOR]

Background: For many years, several studies drew attention to the possible nephrotoxic effects of silica and distinct renal dysfunction involving glomerular and renal tubules in workers exposed to silica. Objective: To determine the early signs of subclinical nephrotoxic effects among some Egyptian workers exposed to silica in the pottery industry. Methods: This study was carried out in El-Fawakhir handicraft pottery area, in Greater Cairo, Egypt. The studied population included 29 non-smoking male workers occupationally exposed to silica in addition to 35 non-smoking administrative male subjects who represented the comparison group in the study. Measured urinary parameters were concentrations of total protein (TP), microalbumin (Malb), activities of alkaline phosphatase (ALP), g-glutamyl transferase (g-GT), lactate dehydrogenase (LDH), kidney injury molecule-1 (KIM-1), and silicon (Si). Results: Silica-exposed workers showed significantly (p<0.05) increased levels of urinary TP, Malb, ALP, g-GT, LDH, and KIM-1 compared with the comparison group. Among the silica-exposed group, increased urinary Si levels were positively and significantly correlated (Spearman's p>0.60, p<0.001 for all variables) with the elevated urinary proteins (including KIM-1) and enzymes levels. All measured urinary parameters were positively and significantly correlated (p>0.75, p<0.001 for all variables) with the duration of work among exposed subjects. No significant correlation was observed between the measured variables and the age of workers. Conclusion: There is associated subclinical glomerular and tubular affection among silica-exposed workers, which is related to the duration and intensity of exposure. [ABSTRACT FROM AUTHOR]