Long-term renal outcomes of patients with non-proliferative lupus nephritis

• Published in: The Korean journal of internal medicine 2023-09, Vol.38 (5), p.769
• Main Authors: Eun-song Kang, Soo Min Ahn, Ji Seon Oh, Yong-gil Kim, Chang-keun Lee, Bin Yoo, Seokchan Hong
• Format: Article
• Language: Korean
• Subjects: Lupus nephritis; Renal outcome; Systemic lupus erythematosus
• ISSN: 1226-3303; 2005-6648

Background/Aims: Although non-proliferative lupus nephritis (LN) (class I, II or V) has been considered as a less severe type of LN, data on long-term renal prognosis are limited. We investigated the long-term outcomes and prognostic factors in non-proliferative LN. Methods: We retrospectively reviewed patients with systemic lupus erythematosus who were diagnosed with LN class I, II, V, or II + V by kidney biopsy from 1997 to 2021. A poor renal outcome was defined as an estimated glomerular filtration rate (eGFR) of < 60 mL/min/1.73 ㎡. Results: We included 71 patients with non-proliferative LN (class I = 4; class II = 17; class V = 48; class II+V = 2), and the overall rate of poor renal outcomes was 29.6% (21/71). The univariate analysis indicated that older age, low eGFR at 6 or 12 months, failure to reach complete remission at 6 months, and LN chronicity score > 4 or activity score > 6 were significantly associated with poor renal outcomes. The multivariate analysis revealed that low eGFR at 6 months (HR 0.971, 95% CI 0.949-0.991; p = 0.014) was significantly associated with poor renal outcomes. Conclusions: Poor renal outcomes occurred in approximately 30% of patients with non-proliferative LN after long-term follow-up. More active management may be needed for non-proliferative LN, especially for patients with eGFR < 60 mL/min/1.73 ㎡ at 6 months follow-up after LN diagnosis.