Predictors of renal outcome in diffuse proliferative glomerulonephritis in systemic lupus erythematosus

Abstract

The occurrence of nephritis is considered to be the most important factor influencing the prognosis in systemic lupus erythematosus (SLE). Despite the apparent histological similarity of the lesions, however, patients with diffuse proliferative glomerulonephritis (DPGN) may exhibit different outcomes. A retrospective study was carried out on 81 SLE patients with DPGN to evaluate the prognostic significance of different clinical, serological and histological variables; in particular, 95 renal biopsies were re-evaluated and the activity and chronicity indices for the patients were determined. A positive correlation was observed between the presence of chronic lesions on renal biopsy and a poor renal outcome (< 0.001). Moreover, in the repeat biopsies the patients with a poor outcome showed a higher degree of chronic lesions. Active lesions and other clinical and serological parameters did not correlate with the outcome.

Outcome of reclassification of World Health Organization (WHO) class III under International Society of Nephrology-Renal Pathology Society (ISN-RPS) classification: retrospective observational study

“…The reclassified class IV LN had higher activity index on initial biopsy, poorer renal response after 1 year of treatment and inferior renal outcome during total followup period. The fact that the reclassified class IV LN group showed higher activity index but not chronicity index is inconsistent with previous reports that suggested poor outcomes associated with the presence of chronic lesions [8,13,14]. A possible explanation is that the initial renal biopsy was performed in very early stage of disease process in our institution.…”

Long-term follow-up of a randomised controlled trial of azathioprine/methylprednisolone versus cyclophosphamide in patients with proliferative lupus nephritis

“…The predictive value of CI was also reported in previous studies 12 15–19,. but the results published on AI were conflicting 12 15 17 18 20–24. Of note, neither CI at baseline nor after 2 years was predictive for renal relapse in our study.…”

Outcome of lupus nephritis in Iranian children: prognostic significance of certain features

“…Despite recent improvement in the diagnosis and treatment of SLE, LN remains a major cause of morbidity and mortality in children [3,29,30]. As in other recent pediatric reports [3,27,29,31,32], the majority of our patients had WHO Class IV nephritis (58.6%). This is almost the same proportion found by Bogdanovic et al [28] and Emre et al [27].…”