Survival and predictors of mortality related to lupus nephritis in Kinshasa, Democratic Republic of Congo: multicenter retrospective follow-up study

Abstract

Context and objective. Lupus nephropathy (LN) is a common complication of systemic lupus erythematosus (SLE), which is life-threatening for patients. The objective of the present study was to describe survival and investigate predictors of mortality in patients with LN. Methods. This was an analytical study of historical cohort conducted in seven hospitals in Kinshasa from January 2013 to December 2023. The primary outcome was mortality at 24 months. Survival curves were produced using the Kaplan Meier method and their comparisons using the Log Rank test. Cox regression was used to determine mortality predictors. Results. Fifty-five patients with LN, all biopsied, were included. Their average age was 35.1 ± 11.2 years, with a preponderance of women (96.4%) and of average socio-economic level (67.3%). Edematous syndrome, polyarthralgia, hypertension and nephrotic syndrome were present in 87.3%, 58.1%, 52.7% and 36.4% respectively. The histological class IV lesion was the most common (40.0%). The therapeutic combination of corticosteroid-plaquénil was the most used (41.8%). Total remission was observed in 56.4% of cases. Mortality was 25.5%, with a median survival of 22 months. Predictors of mortality were pericarditis (HRa=7, p=0.019) and low socio-economic level (HRa=4, p=0.022). Conclusion. LN is associated with high mortality in the study settings, favored by the low socio-economic level and the percarditis.Received: November 26th, 2024Accepted: April 1st, 2025