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Objectives Lupus nephritis (LN) presents differently across geographic regions, with higher prevalence in African, Asian, and Hispanic populations. The aim of this study was to provide a comprehensive characterization of LN within the Guatemalan population.Methods Records of 138 patients diagnosed with LN followed from December 2008 to April 2025 were analyzed in a retrospective study. These patients are part of a lupus cohort at a rheumatology center in Guatemala, specifically at the ‘Autonomía’ Unit of the Guatemalan Social Security Institute (ISLA). We included patients diagnosed with LN either clinically or histologically, summarizing their characteristics with frequencies, percentages, means, and standard deviations.Results Eighty-seven percent of participants were women, with an average age of 40.75 years. The average ages at diagnosis were 28.65 years for SLE and 32.01 years for LN, with an average interval of 3.36 years between the two diagnoses. The most common type of LN was IV class, found in 29.7% of cases. Hypertension was present in 46.4% of patients, and 53.6% had proteinuria levels ranging from 1 to 5 grams. At diagnosis, 13.8% were in End-Stage Renal Disease (ESRD). Musculoskeletal disorders occur in 50% of cases. Among patients with ESRD, 9.56% showed improvement; 72.72% improved after transplantation, and 30.77% after induction therapy. For treatment, 57.2% received cyclophosphamide (CYC) and 42.8% received mycophenolate mofetil (MMF) as induction. MMF was used for maintenance in 69% of cases, a total of 14.5% of patients received rituximab as a rescue therapy, while 20.3% were treated with CYC as a reinduction therapy. In the current year, 39% were active, 21% had current ESRD, and the death rate was 5.1%.Abstract PO:09:231 Table 1–2Conclusions In our population, 49% of patients present with proteinuria at initial diagnosis, as reported in the ISLA cohort, making it the most common manifestation of SLE. This study highlights the relationship between LN findings and those of other Latin American countries. The most common LN types are proliferative, often severe, and have poor treatment responses. In our population, these cases typically arise within the first three years following a diagnosis of SLE. Moreover, they can elevate the risk of progression to ESRD in our country.