Cardiovascular risk in lupus nephritis : do renal disease-related and other traditional risk factors play a role ?

Abstract EN

This study was performed to evaluate the prevalence of thickened carotid intima media thickness (CIMT) in a Sri Lankan cohort of lupus nephritis (LN) patients and to identify associations between traditional cardiovascular disease (CVD) and LN-related risk factors with increased CIMT.

Consecutive patients with biopsy-proven LN were evaluated for conventional CVD risk factors, renal parameters and extent of organ involvement in this cross-sectional study.

Current disease activity and damage were assessed by the British Isles Lupus Activity Group (BILAG) score and the Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) damage index, respectively.

CIMT was assessed by B Mode grey scale ultrasonography.

Increased CIMT was defined as CIMT more than the 75th percentile based on cutoffs from the “Carotid Atherosclerosis Progression Study.” Forty patients (98 % female), with a mean age of 38 years (age range of 20–50) and of South Asian descent, were evaluated.

The mean duration of disease of 6.15 years (SD = 4.66).

The overall prevalence of cardiovascular events was low and included previous acute coronary syndromes in 7.5 %, stable angina in 5 %, cerebrovascular accidents in 7.5 % and transient ischemic attacks in 2.5 % of the patients ; 72.5 % had hypertension (HTN) [mean blood pressure (BP) 140 / 80 mm Hg] ; 32.5 % had dyslipidemias (mean serum cholesterol 5.9 ; SD = 5.6) and 25 % had diabetes (mean blood sugar 103.7 ; SD = 15.6).

Forty percent were obese and 20% were overweight (Asian cutoffs).

Increased CIMT (57.5 %) and atherosclerotic plaques (15.36 %) indicated a high CVD risk in this cohort.

Diabetes (P = 0.016), HTN (P = 0.002), dyslipidemia (P = 0.002) and obesity (P = 0.048) were associated with thickened CIMT.

The only LN-related risk factor associated with thickened CIMT (P < 0.05) was the SLICC / ACR damage index.

The independent predictors of thickened CIMT determined by logistic regression analysis were HTN and dyslipidemia.