Predictive value of clinical, laboratory, pathologic, and treatment variables in steroid/immunosuppressive resistant lupus nephritis

J Clin Apher. 1988;4(1):30-4. doi: 10.1002/jca.2920040107.


Twenty-seven patients with lupus nephritis and nephrotic syndrome had persistent disease activity despite an adequate trial of corticosteroids and immunosuppressive drugs; 30% were Asians, compared with 7% of our overall SLE population. Two years later, seven had a very good outcome and seven a poor outcome. Thirty clinical, pathological, laboratory, and treatment variables were analyzed in a good versus poor responder subset comparison in an effort to determine which factors were associated with favorable outcome. Administration of pulse steroids (P = .069) and a low biopsy chronicity index (P = .048) were associated with the good responder subset. Serum creatinine, biopsy class, blood pressure, complement, and anti-DNA values at entry as well as the choice of immunosuppressive drug were not helpful in predicting outcome. All seven good responders were plasmapheresed (P = .026). Patients with refractory lupus nephritis who have a low biopsy chronicity index may benefit from the use of pulse steroids or plasmapheresis, and controlled studies are suggested.

MeSH terms

  • Adult
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage*
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Lupus Nephritis / metabolism
  • Lupus Nephritis / pathology
  • Lupus Nephritis / therapy*
  • Male
  • Nephrotic Syndrome / metabolism
  • Nephrotic Syndrome / pathology
  • Nephrotic Syndrome / therapy*
  • Plasmapheresis / methods*
  • Prognosis


  • Glucocorticoids
  • Immunosuppressive Agents