Caracterización de la actividad lúpica en sistema nervioso central y periférico de pacientes con LES y enfermedad renal crónica en estadio final

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown cause. Neuropsychiatric involvement is a relatively common complication during lupus activity and is characterized by focal neurological syndromes, diffuse psychiatric syndromes, and / or peripheral nervous system involvement. There is significant variability in the prevalence and incidence of these manifestations with a range of 4-91% for CNS involvement and 8-40% for the PNS. It usually occurs during the early course of the disease and can be the debut symptom in 39-50% of SLE patients. End-stage chronic kidney disease is a common complication of patients with SLE, and dialysis therapy has been associated with disease remission. However, some recent studies have found persistence of disease activity after the onset of kidney complications. Recent data show that more than 50% of patients with SLE will develop clinically relevant nephritis at some point during the course of their disease, while in 20% of these patients, kidney damage progresses to end-stage renal disease (CKD5D) . The divergence in the studies on lupus activity after the start of renal replacement therapy makes it necessary to carry out new studies that make it possible to elucidate the behavior of the disease before and after its onset. Therefore, the purpose of the present investigation is to describe the effect of dialysis on the lupus activity of the nervous system in patients with SLE and end-stage chronic kidney disease. In conclusion, we found that lupus activity in the nervous system is less frequent (3%) in patients with RRT vs (12%) in patients without RRT. Additionally, after 1 year of initiating RRT, it seems to decrease the risk of autoimmune activity.