Response to treatment as a predictor of longterm outcome in patients with lupus nephritis

J Rheumatol. 1994 Nov;21(11):2052-7.

Abstract

Objective: To evaluate response to therapy over one year as a predictor of several longterm outcomes in lupus nephritis.

Methods: Response to treatment was evaluated by comparing serum creatinine and 24 h urine protein excretion at initial renal biopsy to those obtained after one year of treatment. Response at one year was evaluated as a predictor of renal failure, death due to lupus nephritis, and total lupus mortality, using survival analysis.

Results: Eighty-five patients with lupus nephritis diagnosed between 1967 and 1983 and followed through 1990 were studied. Change in proteinuria was a powerful predictor of renal failure (p = 0.001) death due to lupus nephritis (p < 0.001) and overall lupus mortality (p = 0.001). In contrast to a recent study of patients selected for severe lupus nephritis, serum creatinine was not found to be of prognostic significance.

Conclusion: Response of proteinuria to treatment over one year is a useful predictor of longterm outcomes in lupus nephritis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biopsy
  • Child
  • Child, Preschool
  • Cohort Studies
  • Creatinine / blood*
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kidney / pathology
  • Lupus Nephritis / drug therapy*
  • Lupus Nephritis / mortality
  • Lupus Nephritis / pathology
  • Male
  • Middle Aged
  • Prognosis
  • Proteinuria / urine*
  • Survival Rate
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Creatinine