Long-term outcome in Japanese patients with lupus nephritis

Lupus. 2014 Oct;23(11):1124-32. doi: 10.1177/0961203314536246. Epub 2014 May 23.


The objective of this study was to clarify the long-term outcome in patients with lupus nephritis (LN) according to the International Society of Nephrology and Renal Pathology Society classification. This retrospective analysis comprised 186 Japanese patients given a diagnosis of LN by renal specimen with a mean observation period of 12 years. Primary end point was defined as death or end-stage renal disease, and standardized mortality ratios were calculated. Five patients presented with histopathological class I, 62 with II, 21 with III or III+V, 73 with IV or IV+V and 25 with V. Fourteen deaths occurred, corresponding to an overall standardized mortality ratio of 3.59 (95% confidence interval 2.02-5.81, p < 0.0001). Kaplan-Meier analysis revealed a 10-year overall survival of 95.7%. Nephrotic proteinuria (≥3.5 g/day) at baseline was identified as an independent poor prognostic factor for overall survival in Cox regression analysis. Kaplan-Meier analysis revealed a 10-year renal survival as 94.3%. Male gender and nephrotic proteinuria at baseline were identified as independent poor prognostic factors for renal survival in Cox regression analysis. In conclusion, LN was associated with a 3.59-fold increase in mortality compared with the general population. Male gender and nephrotic proteinuria were predictive for poor renal outcome.

Keywords: Nephritis; renal lupus; systemic lupus erythematosus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Female
  • Humans
  • Japan
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Failure, Chronic / etiology
  • Lupus Nephritis / mortality
  • Lupus Nephritis / physiopathology*
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Proteinuria / epidemiology*
  • Proteinuria / etiology
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Survival Rate
  • Time Factors
  • Young Adult