Relación entre grado de proteinuria y sedimento urinario activo con clasificación histopatológica y hospitalización en los pacientes con nefritis lúpica de un centro de referencia del Caribe colombiano entre enero 2013 y diciembre 2022

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dc.contributor.advisorAroca Martínez, Gustavo
dc.contributor.advisorVarela, Lourdes
dc.contributor.authorAraque Libreros, Sarai Elena
dc.contributor.authorAli Salloum, Waeel Yamil
dc.coverage.spatialBarranquillaspa
dc.creator.emailaraquel@unilibre.edu.cospa
dc.creator.emailwaeely-alis@unilibre.edu.cospa
dc.date.accessioned2023-12-13T21:03:04Z
dc.date.available2023-12-13T21:03:04Z
dc.date.created2023-07
dc.description.abstractLa nefritis lúpica (NL) es la complicación más frecuente y grave del Lupus Eritematoso Sistémico (LES), evoluciona a enfermedad renal terminal en aproximadamente 10 % de los pacientes, siendo uno de los principales determinantes de la clasificación histológica. La biopsia es el patrón oro para el diagnóstico, no obstante, dadas las limitaciones, se estudian marcadores otros séricos y urinarios que pueden realizar un abordaje menos invasivo. Objetivo: Analizar la relación entre el grado de proteinuria y sedimento urinario activo con enfermedad proliferativa y exacerbación en pacientes con nefritis lúpica de un centro de referencia del caribe colombiano entre enero 2013 y diciembre 2022. Metodología: Se presenta un estudio retrospectivo, basado en el análisis de las características clínicas, parámetros bioquímicos y urinarios de pacientes con NL del programa de LES en una Clínica de Barranquilla. Se realizó una prueba de normalidad, a las variables continuas se les hicieron estadísticas descriptivas y las cualitativas se representaron en frecuencias absolutas y porcentaje. Se realizó una regresión logística para cálculo de OR, la significancia fue de p < 0.05. Resultados: En este estudio se evaluaron 96 participantes. Al comparar las clases histopatológicas, se encontró una relación positiva de los subtipos proliferativos con mayor grado de proteinuria, sedimento urinario activo, mayor puntuación del SLEDAI-2K, elevación de creatinina y el índice de cronicidad, no se estableció una relación estadísticamente significativa entre un sedimento urinario activo o la severidad de la proteinuria con riesgo superior de agudización y hospitalización. Por su parte, se anticipa que, por cada unidad de aumento en la creatinina, los pacientes tienen 2.25 veces más probabilidades de ser hospitalizados. Conclusión: Estos hallazgos indican que la presencia de proteinuria y sedimento urinario activo es superior en pacientes con subtipos proliferativos de enfermedad, sin embargo, no se relacionan con mayor riesgo de hospitalización. Por otro lado, la elevación de los niveles de creatinina sérica resultó ser una variable que se relaciona con una mayor frecuencia de hospitalización y debe alertar al clínico a un cambio en el abordaje terapéutico para prevenir resultados clínicos desfavorables.spa
dc.description.abstractenglishLupus nephritis (LN) is the most frequent and serious complication of systemic lupus erythematosus (SLE), progressing to end-stage renal disease in approximately 10% of patients, with histological classification being a major determinant. Biopsy serves as the gold standard for diagnosis; however, due to limitations, other serum and urinary markers are being studied to facilitate a less invasive approach. Objective: To analyze the relationship between the degree of proteinuria and active urinary sediment with proliferative disease and exacerbation in patients with lupus nephritis from a reference center in the Colombian Caribbean region between January 2013 and December 2022. Methodology: A retrospective study is presented, based on the analysis of clinical characteristics, biochemical, and urinary parameters of LN patients from the SLE program at a clinic in Barranquilla. A normality test was conducted, continuous variables were subjected to descriptive statistics, and qualitative variables were represented in absolute frequencies and percentages. Logistic regression was performed to calculate odds ratios (OR), with significance set at p < 0.05. Results: This study evaluated 96 participants. When comparing histopathological classes, a positive relationship was found between proliferative subtypes and higher degrees of proteinuria, active urinary sediment, higher SLEDAI-2K scores, elevated creatinine, and the index of chronicity. However, no statistically significant relationship was established between active urinary sediment or proteinuria severity and increased risk of exacerbation and hospitalization. On the other hand, it was determined that for each unit increase in creatinine, patients had 2.25 times higher odds of being hospitalized. Conclusion: These findings indicate that the presence of proteinuria and active urinary sediment is higher in patients with proliferative disease subtypes; however, they are not associated with an increased risk of hospitalization. Conversely, elevated levels of serum creatinine were found to be a variable associated with a higher frequency of hospitalization, alerting clinicians to consider a change in therapeutic approach to prevent unfavorable clinical outcomes.spa
dc.description.sponsorshipUniversidad Libre Seccional Barranquilla -- Facultad de Ciencias de la Salud -- Especialización en Medicina Internaspa
dc.formatPDFspa
dc.identifier.urihttps://hdl.handle.net/10901/27875
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dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.subjectNefritis lúpicaspa
dc.subjectSedimento Urinariospa
dc.subjectProteinuriaspa
dc.subjectCreatininaspa
dc.subjectHospitalizaciónspa
dc.subject.lembNefritis lúpicaspa
dc.subject.lembProteinuriaspa
dc.subject.lembEnfermedades renalesspa
dc.subject.lembLupus eritematoso sistémicospa
dc.subject.subjectenglishLupus nephritisspa
dc.subject.subjectenglishUrinary sedimentspa
dc.subject.subjectenglishProteinuriaspa
dc.subject.subjectenglishCreatininespa
dc.subject.subjectenglishHospitalizationspa
dc.titleRelación entre grado de proteinuria y sedimento urinario activo con clasificación histopatológica y hospitalización en los pacientes con nefritis lúpica de un centro de referencia del Caribe colombiano entre enero 2013 y diciembre 2022spa
dc.type.driverinfo:eu-repo/semantics/bachelorThesisspa
dc.type.localTesis de Especializaciónspa

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