OBJECTIVES: To study the pattern of Adverse events rates among Lupus Nephritis, IgA nephropathy and Renal transplant patient associated with the use of immunosuppressive agents

METHODS: A retrospective observational study was conducted at tertiary care teaching Hospital, Karnataka, India. A total of 316 Patients who met the inclusion criteria and diagnosed with lupus nephritis, IgA nephropathy and renal transplant were enrolled retrospectively into the study. Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 was used to analysis and grade the adverse events obtained from the study population.

RESULTS: Out of 316 patients included in the study analysis, Lupus nephritis (155), IgA nephropathy (77) and Renal transplant (84). Among these three groups of patients, females 147 (94.8%) had the most lupus nephritis, while males 67 (79.8%) had renal transplant. The adverse event rate with immunosuppressive medications in kidney transplant was 89.3 percent, which was higher than the 80 percent rate for lupus nephritis patients and 37.7% for IgA nephropathy patients. Female patients had more adverse events in Lupus nephritis (117 (94.4), but males had higher rates of adverse events in IgA nephropathy and renal transplant patients (19 (65.5%) and 59 (78.7). According to the CTCAE classification, infection was found to be the most common adverse event in the three disease populations. New onset diabetes (31%) and gastrointestinal disorders (34.9%) occurred more frequently in renal transplant patients compared to lupus nephritis and IgA nephropathy. Notable differences were identified in the incidence of adverse events associated with specific combinations of immunosuppressive therapy. Further, most episodes of adverse events are mild to moderate (Grade 1 or 2).

CONCLUSIONS: Infection is the most common adverse event in three disease population followed by gastrointestinal disorder irrespective of immunosuppressant taken. Urinary tract infection was the common type of infection seen in Lupus nephritis and renal transplant patients.