Histological predictors of renal outcome in lupus nephritis: the importance of tubulointerstitial lesions and scoring of glomerular lesions

Lupus
B ObrișcăG Ismail

Abstract

Introduction Lupus nephritis (LN) affects nearly 60% of patients with systemic lupus erythematosus and up to 30% of them will progress to end-stage renal disease (ESRD), despite receiving aggressive immunosuppressive therapy. The prognostic value of ISN/RPS classification is controversial. Therefore, we aimed to identify clinical and pathological predictors of outcome in LN patients independent of this classification. Material and methods Thirty-seven patients with LN who underwent percutaneous kidney biopsy between 1997 and 2016 were included in this study. Twenty clinical and twenty histological variables were tested for their association with a composite end-point of doubling of serum creatinine, ESRD and death. Univariate and multivariate Cox proportional hazard regression analysis were performed to identify independent predictors of outcome. Results During a median follow-up period of 48 months (IQR: 17.5-120 months), 21.6% of patients reached the composite end-point. The overall survival rate of our cohort was 89% at one year, 86% at five years, 74% at 10 years and 64% at 20 years. Patients with Class IV LN showed the worst prognosis with 44% survival at 10 years, while those who additionally showed crescents and global s...Continue Reading

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Citations

Oct 5, 2019·Journal of Clinical Medicine·Bogdan ObrișcăGabriel Mircescu
Aug 8, 2019·Current Opinion in Rheumatology·Anne DavidsonMeggan Mackay
Mar 7, 2020·Current Opinion in Nephrology and Hypertension·Lidia AnguianoHans-Joachim Anders
Jul 18, 2020·International Journal of Rheumatic Diseases·Satish HaridasanHarbir Singh Kohli
Jun 6, 2020·Current Rheumatology Reports·Myrto KostopoulouGeorge Bertsias
Mar 9, 2021·International Urology and Nephrology·Kornwipa KrassanairawiwongBancha Satirapoj
Apr 29, 2021·Modern Rheumatology·Peng LiuZhangxiu He
May 1, 2021·International Journal of Molecular Sciences·Bogdan ObrișcăGener Ismail
May 1, 2021·Journal of Clinical Medicine·Maxence Tailliar On Behalf Of The Groupe Coopératif Sur le Lupus Rénal Gclr

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Methods Mentioned

BETA
biopsy
biopsies

Software Mentioned

SPSS

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