Prognostic value of renal biopsy and clinical variables in patients with lupus nephritis and normal serum creatinine

Objective. To evaluate factors with possible influence on the renal outcome in patients with lupus nephritis but without chronic renal insufficiency (CRI). Methods. Renal biopsies from 94 patients were re-assessed with regard to WHO class, activity, chronicity and tubulointerstitial indices without...

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Bibliographic Details
Published in:Scandinavian journal of rheumatology 1999, Vol.28 (5), p.288-299
Main Authors: Jacobsen, Søren, Starklint, Henrik, Petersen, Jørgen, Ullman, Susanne, Junker, Peter, Voss, Anne, Rasmussen, Jens Møller, Tarp, Ulrik, Poulsen, Lone Hvidfeldt, van Overeem Hansen, Gert, Skaarup, Birgitte, Hansen, Troels Mørk, Pødenphant, Jan, Halberg, Poul
Format: Article
Language:English
Subjects:
Adolescent
Adult
Analysis of Variance
Biological and medical sciences
Biopsy
Child
Child, Preschool
Cohort Studies
Creatinine - blood
Female
Humans
Hypertension
Infant
Kidney - pathology
Kidney Failure, Chronic - etiology
Kidney Failure, Chronic - pathology
Lupus Nephritis - blood
Lupus Nephritis - pathology
Lupus Nephritis - physiopathology
Male
Medical sciences
Predictive Value of Tests
Prognosis
Proteinuria
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Serum Albumin - analysis
Treatment Outcome
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Summary:Objective. To evaluate factors with possible influence on the renal outcome in patients with lupus nephritis but without chronic renal insufficiency (CRI). Methods. Renal biopsies from 94 patients were re-assessed with regard to WHO class, activity, chronicity and tubulointerstitial indices without knowledge of clinical features. The outcome parameters were CRI defined as irreversibly increased serum creatinine and renal end stage disease. Results. The risk ratios (RR) of developing CRI were 2.6 for active urinary sediment, 3.1 for hyaline thrombi and 7.3 for glomerular leukocyte exudation. The RR of renal end stage disease was 5.0 when the duration of renal disease exceeded one year at the time of biopsy and 4.3 when biopsy disclosed a class IV lesion. Glomerular sclerosis was also associated to renal end stage disease. Conclusion. Early renal biopsy and the abovementioned signs of active renal disease carry prognostic information that may have significant therapeutic implications.
ISSN:0300-9742
1502-7732
DOI:10.1080/03009749950155464