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Renal flares in 91 SLE patients with diffuse proliferative glomerulonephritis
Marta Mosca1, Walter Bencivelli, Rossella Neri
1Rheumatology Unit, University of Pisa, Pisa, Italy. marta@sssup.it
Kidney International
|March 29, 2002
Summary
Systemic lupus erythematosus (SLE) patients with diffuse proliferative glomerulonephritis (DPGN) who experience renal flares are at higher risk for end-stage renal disease (ESRD). Early identification of younger patients with active kidney lesions can help predict these flares.
Area of Science:
- Nephrology
- Rheumatology
- Immunology
Background:
- Diffuse proliferative glomerulonephritis (DPGN) affects 25-30% of systemic lupus erythematosus (SLE) patients, often leading to end-stage renal disease (ESRD).
- Renal flares are a significant risk factor for disease progression to ESRD in SLE patients with DPGN.
Purpose of the Study:
- To determine the incidence and prognostic significance of renal flares in SLE patients with DPGN.
- To identify predictors for renal flare occurrence in this patient cohort.
Main Methods:
- Retrospective study of 91 SLE patients with DPGN and renal involvement.
- Inclusion criteria: minimum 6-month follow-up post-renal biopsy and 3-month steady improvement in renal manifestations.
Main Results:
- Renal flares occurred in 54% of patients post-biopsy and treatment.
- Younger age at biopsy, high activity index, and karyorrhexis predicted renal flares.
- Renal flares, specific flare types, creatinine levels, and histological indices correlated with doubling serum creatinine.
Conclusions:
- Younger SLE patients with extensive, active renal lesions are a subgroup at higher risk for renal flares.
- Renal flares are significant predictors of doubling serum creatinine, indicating disease progression.