[Prognostic factors in children with lupus nephritis]

Renal involvement in systemic lupus erythematosus in children is very often observed. Clinical manifestation of nephropathy has been detected in 70% of patients. Lupus nephritis (LN) has a recurrent course and remains a cause of chronic renal failure. The aim of this study was to analyse retrospectively the clinical course and prognostic factors in children with LN. Twenty five children with LN were included in the study, 18 girls and 7 boys, patients were observed 6 month to 15 years (mean 6.5 years). We analyzed age at onset of the disease, first symptoms before admission to hospital, clinical symptoms, biochemical markers and treatment. Percutaneous renal biopsy was performed in all children at the beginning of the disease. At the time of the observation clinical remission with normal renal function was achieved in 13 patients, in 8 children developed chronic renal failure requiring conservative treatment, 1 child remained on maintenance hemodialysis, 3 patients died. Hypertension, neurological symptoms, presence of necrotic changes and interstitial fibrosis in the biopsy material are the main poor prognostic factors. The correlation between the age of lupus onset, impaired renal function at the beginning of the disease, anemia, proteinuria, and poor renal outcome was not found.