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Inicio Revista Colombiana de Reumatología Enfermedad renal terminal en lupus eritematoso sistémico
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Vol. 16. Issue 2.
Pages 167-182 (June 2009)
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Vol. 16. Issue 2.
Pages 167-182 (June 2009)
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Enfermedad renal terminal en lupus eritematoso sistémico
End-Stage Renal Disease in Systemic Lupus Erythematosus
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Luis Alonso González Naranjo1, Gloria María Vásquez2, Luis Alberto Ramírez Gómez3
1 Profesor Sección de Reumatología, Hospital Universitario San Vicente de Paúl, Universidad de Antioquia. Medellín, Colombia. Clínica Universitaria Bolivariana
2 Grupo de Reumatología, Universidad de Antioquia, Grupos de Inmunología celular e inmunogenética. Facultad de Medicina, Universidad de Antioquia. Medellín, Colombia
3 Profesor Sección de Reumatología, Hospital Universitario San Vicente de Paúl, Universidad de Antioquia. Medellín, Colombia
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Resumen

La enfermedad renal terminal (ERT) se presenta entre un 5% y un 20% de los pacientes con lupus eritematoso sistémico (LES) en los primeros 10 años luego del diagnóstico de nefritis lúpica (NL). La actividad clínica y serológica disminuye o mejora dramáticamente una vez la NL progresa a ERT. La tasa de supervivencia de los pacientes con LES en diálisis es comparable a la de los pacientes no-lúpicos en diálisis y mejor que la de pacientes con otras enfermedades reumáticas en diálisis. Tras el trasplante renal, no hay diferencias en la supervivencia de los pacientes o del injerto en pacientes lúpicos comparado con pacientes no-lúpicos. Al igual que en pacientes nolúpicos, los resultados son mejores con trasplante de donante vivo que con trasplante de donante cadavérico. La tasa de recurrencia de la NL en riñones trasplantados es baja y rara vez es responsable de la pérdida del injerto.

Palabras clave:
lupus eritematoso sistémico
nefritis lúpica
enfermedad renal terminal
Summary

End-stage renal disease (ESRD) occurs in 5%–20% of all systemic lupus erythematosus (SLE) patients within 10 years after diagnosis of lupus nephritis (LN). Both clinical and serological lupus activities decrease or dramatically improve once ESRD ensues. The survival rate of lupus patients on dialysis is comparable to that of the non-SLE dialysis patients and is better than that of several other rheumatic diseases. Following renal transplantation, there is no difference in patient and graft survival in lupus versus non-lupus patients. Like their non-lupus counterparts, SLE transplant patients do better with living relative grafts. The recurrence rate of LN in transplanted allografts is low and rarely responsible for graft loss.

Key words:
systemic lupus erythematosus
lupus nephritis
end-stage renal disease
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