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[Risk factors for the development of thrombotic complication in patients with lupus erythematosus and lupus nephropatic].

INTRODUCTION
Thrombotic events constitute a frequent complication in patients with systemic lupus erythematosus (SLE) and are associated with increased morbidity and mortality of these patients.


OBJECTIVE
To identify clinical and laboratorial factors associated with the development of arterial or venous thrombosis in patients with SLE and lupus nephritis (LN).


MATERIAL AND METHODS
We reviewed 200 files of patients with SLE and LN to determine if any patients had presented a symptomatic episode of thrombosis confirmed by an image study. We collected demographic, clinical and laboratory data. Logistic regression was used to determine clinical and laboratorial factors associated with thrombotic complications.


RESULTS
There were 25 thrombotic events in 23 patients, of which 68% (n = 17) occurred in the venous bed. The overall incidence rate of thrombotic events was 29.1 per 1,000 patient-years. The class IV was the most frequent class of LN with 40.8% of cases. There were no differences in the distribution of the different classes of NL, eGFR, magnitude of proteinuria and markers of lupus activity among patients with and without thrombotic complications. In multivariate analysis, previous diagnosis of antiphospholipid-antibody syndrome (APS) (OR = 126; IC95% 11.3-1419; p < 0.001), serositis (OR = 5; IC95% 0.95-26.9; p = 0.05) and history of arterial thrombosis (OR = 24; IC95% 1.8-314; p = 0.01) were associated with thrombotic complications and the use of ACE inhibitors showed a protective effect (RM = 0.19; IC95% 0.03-0, 98; p = 0.04).


CONCLUSIONS
Thrombotic complications were frequent in our population. Risk factors related with thrombotic complications were a personal history of arterial thrombosis, serositis and previous diagnosis of APS. Interestingly, the use of ACE inhibitors was associated with reduced risk. We found no greater or lesser risk of thrombosis with renal factors such as proteinuria, histological type of LN and eGFR.