Glomerular filtration rate predicts arterial events in women with systemic lupus erythematosus.

Abstract

To determine whether renal function predicts the development of cardiovascular disease and other arterial vascular events in patients with SLE. An inception cohort of 437 females was studied. Baseline estimated glomerular filtration rate (eGFR) was calculated using serum creatinine and the abbreviated Modification of Diet in Renal Disease Study Group formula. Arterial events including myocardial infarction, angina, transient ischaemic attacks, cerebral vascular accidents and other arterial events were documented at up to 15 years since the first visit. Disease activity was determined using SLEDAI. Patients were classified into those with or without arterial events and further into events that occurred within or after 3 years since the first visit (events <3 years, events ≥3 years). The association between eGFR and risks of arterial events was investigated using the Cox proportional hazards model. There was a total of 58 arterial events of which 51.9% were events ≥ 3 years. Patients with arterial events had a significantly lower baseline eGFR and were significantly older than those without arterial events. Furthermore, baseline eGFR was significantly lower in events <3 years compared with events ≥ 3 years. Baseline eGFR, age and baseline SLEDAI were significantly associated with the risks of arterial events [eGFR: hazard ratio (HR) = 0.986; age: HR = 1.032; SLEDAI: HR = 1.041]. Lower baseline eGFR, older age and higher SLEDAI score were significantly associated with increasing odds of developing arterial events at an earlier stage of SLE.