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Systemic lupus with nephritis: a long-term study.

J S Cameron, D R Turner, C S Ogg

    The Quarterly Journal of Medicine
    |January 1, 1979
    PubMed
    Summary
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    Systemic lupus erythematosus patients with nephritis show improved survival rates, with renal failure deaths occurring later. Despite advances, treatment side effects remain a significant concern for lupus nephritis patients.

    Area of Science:

    • Nephrology
    • Rheumatology
    • Immunology

    Background:

    • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organs, including the kidneys.
    • Lupus nephritis, a severe manifestation of SLE, significantly impacts patient prognosis and survival.
    • Long-term outcomes and prognostic factors in lupus nephritis require ongoing investigation.

    Purpose of the Study:

    • To evaluate the long-term survival rates and causes of mortality in patients with systemic lupus erythematosus and clinical evidence of nephritis.
    • To analyze the correlation between renal biopsy histology and patient outcomes in lupus nephritis.
    • To assess the impact of modern treatment strategies on the prognosis of severe lupus nephritis.

    Main Methods:

    • Retrospective cohort study of 71 patients with systemic lupus erythematosus and nephritis over 15 years.

    Related Experiment Videos

  • Survival analysis calculated from the onset of clinical nephritis and clinical lupus.
  • Renal biopsy histology (mild/focal, membranous, diffuse proliferative) was correlated with long-term outcomes.

    • Main Results:

    • Five-year survival from clinical nephritis was 76%, and ten-year survival was 57%.
    • Survival from clinical lupus onset was 80% at five years, decreasing to 55% by twenty years.
    • No significant difference in long-term outcomes was observed across different renal biopsy histological groups.
    • Mortality causes included renal failure (11 patients), sepsis (6), and cerebral lupus (2).
    • Death from renal failure is now a late event, and overall prognosis has improved.

    Conclusions:

    • The prognosis for severe lupus nephritis has improved, with better survival rates than previously reported.
    • While renal histology did not predict long-term outcome, treatment modifications, including cytotoxic drugs like azathioprine, may have reduced cardiovascular mortality.
    • Treatment side effects continue to be an important factor contributing to mortality and morbidity in lupus nephritis patients.