Lupus nephritis as an independent risk factor for carotid atherosclerosis in patients with systemic lupus erythematosus.
Among 151 patients with systemic lupus erythematosus, lupus nephritis was an independent risk factor for carotid atherosclerosis, with carotid plaque present in 47.9% of those with nephritis versus 28.7% of those without.
Background
Systemic lupus erythematosus (SLE) is associated with an elevated risk of atherosclerosis, and lupus nephritis (LN) represents a critical and potentially fatal form of target-organ damage. This study set out to determine the prevalence of LN among SLE patients and its correlation with carotid atherosclerosis (CA).
Study design
A total of 151 SLE patients were studied (mean age 50.9 ± 14.6 years; 87.4% women). The 2024 KDIGO guideline was used to assess LN prevalence, and carotid artery ultrasound was performed to identify plaque and intima-media thickness (IMT). Logistic regression analysis was used to identify independent risk factors for carotid atherosclerosis.
Key findings
LN was present in 47.0% of SLE patients and CA in 37.7%. Patients with LN had a higher carotid plaque ratio (47.9% vs 28.7%, p = 0.015) and greater IMT (1.0 [0.7, 1.1] mm vs 0.8 [0.7, 1.0] mm, p < 0.010) than those without LN. On logistic regression, the presence of LN (p = 0.002), male sex (p = 0.039), age (p < 0.001), and serum total cholesterol (p = 0.016) were independent risk factors for CA. LN and related renal parameters showed a strong association with CA.
Clinical implications
The authors conclude that LN prevalence correlated significantly with carotid atherosclerosis in SLE, so early identification of LN flags patients at high risk of CA. They suggest this may enable targeted prevention and reduce cardiovascular morbidity in this population. The study is cross-sectional in design, so it establishes association rather than a causal sequence.
Category
KDIGO
Source
Clin Rheumatol
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