Features and outcomes of lupus nephritis in Morocco: analysis of 114 patients

Intissar Haddiya,¹ Hakim Hamzaoui,¹ Nabil Tachfouti,² Zitouna Al Hamany,³ Aicha Radoui,¹ Najoua Zbiti,¹ Yamama Amar,¹ Hakima Rhou,¹ Loubna Benamar,¹ Naima Ouzeddoun,¹ Rabea Bayahia<sup>1

1</sup>Department of Nephrology, Dialysis, and Renal Transplantation, Ibn Sina University Hospital, Rabat, Morocco; ²Department of Epidemiology, Fez, Morocco; ³Department of Pathology, Rabat Children's Hospital, Rabat, Morocco

Background: There is wide variation in clinical presentation and outcome of lupus nephritis (LN) among different ethnic groups. Few data for LN exist on North Africans, especially those from Morocco. The aim of our study was to review retrospectively the features and outcome of LN in Moroccan patients.
Patients and methods: We performed a single-center retrospective study. A total of 114 patients with LN were included. All patients met American Rheumatism Association criteria. LN was classified according to the International Society of Nephrology/Renal Pathology Society classification. We adopted previously defined outcome criteria for LN.
Results: There were 101 females and 13 males, with a mean age of 29.9 years. At first presentation, we noted hypertension in 33%, hematuria in 76%, nephrotic syndrome in 53%, and renal failure in 60% of cases. Renal biopsy revealed predominant proliferative classes in more than 80% of patients. Patients received different regimens mainly based on intravenous cyclophosphamide. After a mean follow-up of 22 months, remission occurred in 45.5%, relapses in 82%, end-stage renal failure in 21%, and death in 16% of cases. Infection and neurological and cardiovascular diseases were the most frequent causes of death.
Conclusion: LN seems to be severe in our study, with a predominance of proliferative forms, severe renal manifestations, and poor renal and overall survival.

Keywords: lupus nephritis, systemic lupus erythematosus, nephritis