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Response to treatment as a predictor of longterm outcome in patients with lupus nephritis
L Fraenkel1, T MacKenzie, L Joseph
1Division of Rheumatology, Montreal General Hospital, McGill University, PQ, Canada.
Objective:
To evaluate response to therapy over one year as a predictor of several longterm outcomes in lupus nephritis.
Methods:
Response to treatment was evaluated by comparing serum creatinine and 24 h urine protein excretion at initial renal biopsy to those obtained after one year of treatment. Response at one year was evaluated as a predictor of renal failure, death due to lupus nephritis, and total lupus mortality, using survival analysis.
Results:
Eighty-five patients with lupus nephritis diagnosed between 1967 and 1983 and followed through 1990 were studied. Change in proteinuria was a powerful predictor of renal failure (p = 0.001) death due to lupus nephritis (p < 0.001) and overall lupus mortality (p = 0.001). In contrast to a recent study of patients selected for severe lupus nephritis, serum creatinine was not found to be of prognostic significance.
Conclusion:
Response of proteinuria to treatment over one year is a useful predictor of longterm outcomes in lupus nephritis.