Anti-Sm is associated with the early poor outcome of lupus nephritis

Int J Rheum Dis. 2016 Sep;19(9):897-902. doi: 10.1111/1756-185X.12880. Epub 2016 Apr 29.


Aim: We investigated whether anti-Smith (Sm) is associated with the outcome of kidney biopsy-proven lupus nephritis.

Methods: We retrospectively analyzed clinical, laboratory and histological results in 90 patients with kidney biopsy-proven lupus nephritis. We defined persistent administration of immunosuppressants for more than 3 months after the kidney biopsy as early poor outcome of lupus nephritis. We compared baseline variables and delta values of lupus nephritis-related variables between patients with and without anti-Sm. The independent predictive values for early poor outcome were analyzed using logistic regression analysis.

Results: The median age was 32.0 years old, and 77 patients (85.5%) were women. Anti-Sm was found in 44 of 90 patients (48.8%). When we analyzed the differences in delta values of variables reflecting the kidney function or the early poor outcome between patients with and without anti-Sm, we found significant difference in the early poor outcome between the two groups (80.0% of patients having anti-Sm vs. 56.5% of those not having anti-Sm, P = 0.022). In multivariate logistic regression analysis, along with age and Systemic Lupus Erythematosus Disease Activity Index, the presence of anti-Sm increased the potential of the early poor outcome of lupus nephritis (odds ratio 2.870, 95% confidence interval, 1.033, 7.976, P = 0.043).

Conclusion: Our data suggest that anti-Sm identified at kidney biopsy might have a predictive value for the early poor outcome of biopsy-proven lupus nephritis during the follow-up period.

Keywords: anti-Sm; immunosuppressants; lupus nephritis; outcome.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Antinuclear / blood*
  • Biomarkers / blood
  • Biopsy
  • Chi-Square Distribution
  • Child
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney / drug effects
  • Kidney / immunology*
  • Kidney / pathology
  • Kidney / physiopathology
  • Logistic Models
  • Lupus Nephritis / blood
  • Lupus Nephritis / diagnosis
  • Lupus Nephritis / drug therapy
  • Lupus Nephritis / immunology*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Young Adult
  • snRNP Core Proteins / immunology*


  • Antibodies, Antinuclear
  • Biomarkers
  • Immunosuppressive Agents
  • snRNP Core Proteins