POS1019 ASSOCIATION OF ANTIPHOSPHOLIPID ANTIBODIES’ PRESENCE IN PATIENTS WITH LUPUS NEPHRITIS WITH THE PROGRESSION OF KIDNEY FAILURE
Authors: E. Łyś, M. Dryglewska, M. Majdan
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Systemic lupus erythematosus (SLE) is associated with an increased mortality, especially in young people with severe disease and organ complications. Whether the presence or absence of antiphospholipid antibodies (aPL) or antiphospholipid syndrome coexisting with SLE is associated with the faster progression of kidney damage remains unclear. The presence of aPL: lupus anticoagulant (LAC), anticardiolipin antibodies (aCL) and anti-β2-glycoprotein I antibodies (a- β2GPI) is associated with an increased risk of thromboembolic events in the arterial, venous and capillary systems or obstetric failures. When considering the SLE patients, mortality is significantly higher among patients with lupus nephritis (LN). Death directly related to kidney disease affects 5-25% of patients with the proliferative form of nephritis. Moreover, 10-30% of patients require renal replacement therapy. <h3>Objectives:</h3> The aim of the study was to determine whether the presence of aPL in SLE patients is an independent risk factor influencing the rate of deterioration of kidney function. <h3>Methods:</h3> For this purpose, a retrospective analysis of the medical history of patients with renal involvement in the course of SLE was performed. The observation included 71 patients diagnosed with SLE and LN (55% biopsy-proven) treated in a single center during 2007-2022. The average: age of the study group was 43,3 years (range 21-82), duration of the disease was 7,3 years (range 1-15), duration of observation was 88,2 months (range 12 to 180). The presence and serological profile of antiphospholipid antibodies (aCL and a-β2GPI in IgG and IgM class, and LAC) of patients was compared with the deterioration of renal function assessed by creatinine concentration (CR) and glomerular filtration rate (eGFR). Is there a relationship between the presence of aPL antibodies including their specific groups, and the deterioration of kidney function, assessed by the difference between the initial and end level of creatinine (the increase of creatinine level indicates a deterioration of kidney function). In addition, the relationship was determined by the difference between the initial and end values of the eGFR indicator (where the decrease of eGFR testifies to the deterioration of kidney function). An U-Mann-Whitney test was conducted to determine these differences <h3>Results:</h3> In the study group, 40% (29/71) of patients had a confirmed presence of at least one of the aPLs in their medical history. A statistically significant increase of creatinine values was observed in the group of patients with the presence of particular types of aPL: for a-β2 GPI antibodies (p&lt;0.005), a-β2 GPI IgG (p&lt;0.035) and LAC a (p&lt;0.005) compared to aPL-seronegative patients. Moreover, the analysis showed a statistically significant decrease of the eGFR value depending on the presence of IgM aCL antibodies (p&lt;0.049), a-β2 GPI antibodies (p&lt;0.036) and lupus anticoagulant (p&lt;0.028). <h3>Conclusion:</h3> In SLE patients with lupus nephritis, the presence of antiphospholipid antibodies such as lupus anticoagulant and anti-B2 GP II antibodies is significantly associated with the progression of functional kidney damage. <h3>REFERENCES:</h3> [1] Yap D, Thong K, Yung S et al. Antiphospholipid antibodies in patients with lupus nephritis: clinical correlations and associations with long-term outcomes. Lupus 2019;28:1460-1467 [2] Morales E., Galindo M. Et al. Update on Lupus Nephritis: looking for a new vision. Nephron 2021;145:1–13 [3] Xourgia E, Tektonidou MG Antiphospholipid syndrome nephropathy: current knowledge and unanswered questions. Clin Immunol 2023 Oct:255:109735.doi:10.1016/j.clim.2023.109735 [4] Scheen M, Adedjouma A, Esteve E et al. Kidney disease in antiphospholipid antibody syndrome: Risk factors, pathophysiology and management Autoimmunity Reviews 21 (2022) 103072 <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Ewa Łyś: None declared, Magdalena Dryglewska: None declared, Maria Majdan Novartis, Medac, Egis, Astra Zeneca.