Histologic features that correlate with the prognosis of patients with lupus nephritis

This study stresses the significance of accurate assessment of renal biopsy material in patients with lupus nephritis in order to determine prognosis. The size of the biopsy sample is important because of the focal nature of the disease. The number of glomeruli that must be present to judge the extent of focal involvement was computed. The correct categorization of a patient's disease is essential to avoid "stage migration." Class III lupus nephritis (focal, segmental) should be divided into mild, moderate, and severe. The amount of prednisone administered was calculated, and it was found that the severity of the renal lesion was of greater prognostic significance than the choice of treatment given. While a classification that includes consideration of chronicity appears useful, this study indicates that the amount of acute inflammatory change in the glomeruli is also an important prognostic indicator.