A Study on Pharmacotherapeutic Management in Patients with Lupus Nephritis with Immunosuppressants

Author(s): Mungara Sai Renuka, Pilla S Surya Durga Devi, Kedem Asha, Bandi Aiswarya, Nambhuri Siva Sai Ganesh, N. Lakshmi Likhitha Reddy, K. Uma Maheswara Rao And V. Siva Kumar

Abstract: Aim: To address the adverse drug reactions associated with all the drugs involved in treatment plan which include immunosuppressants. Methods: A Retrospective observational study was carried out in Nephrology department at Sri Venkateswara Institute of Medical Sciences. This study mainly focuses on pharmacotherapy of lupus nephritis as induction and maintenance therapy with immunosuppressants and corticosteroids. There is a chance of adverse drug reactions with the therapeutic regimens. So, these reports were also analyzed for adverse drug reactions, causality, severity and reventability assessment. Results: A total of 75 patients were included in our study. Patients with clinical features of lupus nephritis satisfying at least 3 of ARA criteria for Systemic lupus erythematosus and diagnosed at the time of renal biopsy were included. The mean age at presentation was 31.02±11.09). Majority members were females (m: f= 1:5). Pedal edema (48%), decreased urine output (17.33%), shortness of breath (16%) is mostly observed adverse drug reactions in our study. The patients were hypertensive (25.33%) and hypothyroidism (10.66%) at the time of presentation. WBC count (7553.93±4266.98), proteinuria (562.8±904.07), serum creatinine (1.64±1.41), serum albumin (2.70±1.47), C3 (22.22%), were estimated in 6 month’s study. Majority belonged to class IV (56%) and class V (10.66%) lupus nephritis. Conclusion: Lupus nephritis is common in female gender in the adult age group with multi system manifestations secondary to immunological involvement (ds DNA) as substantiated in our study. The disease management requires corticosteroids, cyclophosphamide, mycophenolate mofetil at different stages for the control of immunological activity as substantiated in our patient group.

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