Clinical outcomes of hydronephrosis in patients with systemic lupus erythematosus.

Abstract

AIM:

Hydronephrosis is a rare complication of systemic lupus erythematosus (SLE). Bladder and/or gastrointestinal involvement in SLE are associated with development of hydronephrosis, but the management and treatment outcomes of hydronephrosis are largely unknown. Therefore, we investigated the clinical manifestations and factors associated with the treatment response in patients with SLE complicated by hydronephrosis.

METHOD:

A retrospective analysis was performed of all 634 SLE patients who underwent computed tomography and/or ultrasonography between January 1998 and December 2013. We reviewed the clinical characteristics and treatment outcomes of patients with SLE-associated hydronephrosis.

RESULTS:

Hydronephrosis was identified in 15 patients with SLE complicated by cystitis and/or enteritis. All patients were treated initially with moderate to high doses of corticosteroids. A follow-up imaging study showed that 11 (73.3%) of 15 patients experienced improvements in hydronephrosis, and urinary obstruction was resolved without urological intervention in the majority of these patients (8/11, 72.7%). The four patients who experienced no improvement in hydronephrosis were older than those who responded to treatment (median age [interquartile range]; 43.0 [37.5-53.0] years vs. 28.0 [21.0-38.5] years; P = 0.026). In addition, delayed treatment (≥ 1 month after onset of symptoms) with corticosteroids was more frequently observed in the non-responding patients than in the responding patients (P = 0.011).

CONCLUSION:

Our findings suggest that treatment with corticosteroids alone leads to favorable outcomes in patients with SLE-associated hydronephrosis, except when treatment is delayed, particularly in elderly patients.

• Authors: Seokchan Hong, Yong-Gil Kim, Soo Min Ahn, Seung-Hyeon Bae, Doo-Ho Lim, Jeong Kon Kim, Chang-Keun Lee, Bin Yoo
• Journal: International journal of rheumatic diseases (Int J Rheum Dis) Vol. 19 Issue 12 Pg. 1317-1321 (Dec 2016) ISSN: 1756-185X [Electronic] England
• PMID: 26224134 (Publication Type: Journal Article)
• Copyright: © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Chemical References

• Adrenal Cortex Hormones

Topics

• Adolescent
• Adrenal Cortex Hormones (administration & dosage)
• Adult
• Age Factors
• Cystitis (drug therapy, etiology)
• Drug Administration Schedule
• Drug Resistance
• Enteritis (drug therapy, etiology)
• Female
• Humans
• Hydronephrosis (diagnostic imaging, drug therapy, etiology)
• Lupus Erythematosus, Systemic (complications, diagnosis, drug therapy)
• Male
• Middle Aged
• Remission Induction
• Retrospective Studies
• Risk Factors
• Time Factors
• Time-to-Treatment
• Tomography, X-Ray Computed
• Treatment Outcome
• Ultrasonography
• Young Adult