Manifestation of Lupus Erythematosus in patients with chronic kidney disasess

Systemic Lupus Erythematosus (SLE) is a chronic multifactorial autoimmune disease characterized by the involvement of many organs mediated by changes and disorders of the immune complex. One of the organs affected by SLE is the kidneys and the appearance of Lupus Nephritis, which is characterized by progressive glomerulonephritis as a result of the deposition of immune complexes in the glomeruli, causing a chronic inflammatory reaction and damage to the renal parenchyma and, over time, gradual progressive damage to renal function.In addition to the numerous complications of Chronic Kidney Disease (CKD), lupus erythematosus is one of the conditions that can lead to end-stage CKD requiring treatment with chronic hemodialysis or kidney transplantation. Recent studies have confirmed that 10-30% of patients with SLE develop LN after several years (3-6 years) and after end-stage chronic kidney disease (CKD), requiring treatment with chronic intermittent hemodialysis (HD) [1,2,3].The most common form of Lupus Nephritis (LN) is chronic glomeru-lonephritis, chronic pyelonephritis and renal fibrosis. The clinical picture of LN is manifested by: proteinuria, hematuria, albuminuria, edema of the face and lower extremities, malar rash, redness of the face in the form of a “butterfly”. hypertension, periorbital edema and edema of the legs, fever, The diagnosis of LN is confirmed by the appearance of proteinuria >100 mg/mmol, hematuria, arterial hypertension, renal biopsy, damage to the glomerular basement membrane, reduction of the glomerular filtration rate (GFR)< 59mL/min/1.73 m2, increase in urea, creatinine, uric acid in serum, hypocalcemia, hyperkalemia and other.The purpose of the paper: was the assessment of renal damage asa result of LN using the results obtained from the examined parameters in patients with chronic kidney disease (CKD).Matherials and Methods: In this prospective cohort research (,, cross-section “) study are included 100 patients with CKD (55 were men with an average age of 58.00±7.60 years old with chronic renal disease and 45 were female with an average age of 56.40 ±10.00 years old), with basic kidney disease.All patients (men+women) were in the third degree a and b according to the degree of glomerular filtration within the limits of values: 30-50 mL/min/1.73 m2, table number 3) with the onset of the disease 6-8 years ago. All patients were monitored in the period,Maj- 2022-Maj-2024. From the total number of patients (100) with chronic renal insufficiency, 18 of them manifested symptoms of LN (women-13 while men-5) and all fulfilled the clinical and laboratory criteria for LN according to the International Society of Nephrology(ISN)/Renal Pathology Society and the Renal Pathology Society (RPS) 2003/2004.Statistical analysis of the examined material: The obtained results from the examined patients with CKD and the control group were statistically processed with arithmetic mean value, standard deviation X ± SD, with studentov, “t” test, Mann-Whitney and Wilcoxon test. The results were processed with the appropriate state of the art statistical program SPSS V26. Results: the results obtained at the beginning of the study (for all patients with LN and CKD: women and men) as well as after 24 months of treatment are presented in tables and graphs number:
4 and 8.Conclusion: from the obtained results we can conclude that LES apparently affects the appearance of renal damage, therefore early detection and treatment of the initial stages of LN seem to affect the reduction of its activity. Therefore, we prefer that timely treatment (with nonsteroidal anti-inflammatory,corticosteroid ther apy,antimalarial,immunosuppressive therapy, antihistamine, ACE inhibitors or Angio-tensin Receptor Blockers (ARBs and antilipemic in patients with pre-uremia should be the main goals and objectives of nephrologists and rheumatologists in order to prevent the progression of the disease towards failure chronic end-stage renal disease.
Key words:skin manifestation,LES,renal diseases.