Severe infections in patients with lupus nephritis treated with immunosuppressants: A retrospective cohort study

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Lupus nephritis (LN) is associated with increased risk of end‐stage renal disease (ESRD) and mortality.1 Hence proliferative LN is usually treated aggressively with immunosuppressive therapy, such as a combination of high dose glucocorticoids and a cytotoxic agent.3 However, patients with systemic lupus erythematosus (SLE) may have intrinsically increased risks for infections due to impaired function of polymorphonuclear neutrophils and functional hyposplaenia that may be further exacerbated by immunosuppressants.4 Several studies have evaluated infections in SLE patients attending general rheumatology clinics or during hospitalizations7; however, SLE patients with extra‐renal manifestations have different therapeutic profiles compared to patients treated for LN.17 In addition, active renal disease is also a risk factor for infection.8 Immunosuppressive therapy for LN has also evolved over the last decade, with low dose cyclophosphamide or mycophenolate mofetil favoured over high dose cyclophosphamide.19 This study aimed to describe the epidemiology and identify risk factors for infections requiring hospitalization among patients with biopsy‐proven LN.
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