Re-biopsy in lupus nephritis

Husein, Raida; Souza, Beatriz Camargo de; Meyer, Thanis; Skare, Thelma Larocca

doi:10.1590/1516-3180.2014.9521711

Cited by 1 publication

(2 citation statements)

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“…This mainly stems from a number of studies that have demonstrated changes in histological class when LN patients relapse. 62,71,72 This has treatment implications since therapy for LN is now based on the histological class of the disease. 48 In membranous nephritis (Class V) for example, it has been shown that as much as 35%…”

Section: Clinically Driven Repeat Renal Biopsies After a Flarementioning

confidence: 99%

“…7,8 One of the important reasons for repeat biopsies in patients with LN is to identify significant class transformations requiring change of therapy. 2,[9][10][11][12][13][14][15] However, there are questions regarding the value of these repeat biopsies if the first biopsy showed proliferative LN given that the same is likely to be seen on repeat biopsy. 15,16 In one study, 84% of patients with proliferative histology in their reference biopsy remained in a proliferative class of LN at repeat biopsy.…”

Section: Introductionmentioning

confidence: 99%

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Clinico-pathological features of repeat renal biopsies in patients with lupus nephritis at Groote Schuur Hospital, Cape Town

Kajawo

Botha

Okpechi

2017

Lupus

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Background Repeat renal biopsies in patients with lupus nephritis are usually done to guide treatment or to establish disease chronicity. Their value is not clear from available literature. There are also no available data in Africa to guide clinicians. Methods This was a retrospective study of patients undergoing a repeat renal biopsy between January 2003 and December 2014 from a single centre in Cape Town, South Africa. Relevant demographic, clinical and histological records of patients with repeat renal biopsies were documented. Comparison of data from first and second renal biopsy was performed. Results Forty-four patients had at least two biopsies done during the study period. Most patients were females (81.8%). The mean biopsy interval was 2.8 ± 1.8 (range 0.38–9.4) years. Proteinuria was the main indication for the repeat biopsy (36.1%). The glomerular filtration rate and proteinuria worsened between the two biopsies ( p = 0.001 and 0.019, respectively) suggesting disease progression. Most patients (65.4%) with a non-proliferative class of lupus nephritis at first biopsy progressed into a proliferative class, whereas patients with initial proliferative lupus nephritis at first biopsy (77.8%) remained as proliferative at repeat biopsy. Treatment was changed in 85% of patients at second biopsy. Conclusion Repeat renal biopsies in patients with lupus nephritis presents a useful means of assessing disease progression and provides guidance regarding modification of treatment. More studies are, however, required to evaluate the value of repeat biopsies and perhaps the need for protocol renal biopsies in patients with lupus nephritis.

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Section: Clinically Driven Repeat Renal Biopsies After a Flarementioning

confidence: 99%