EVALUATION OF CLINICAL AND PATHOLOGICAL FINDINGS AND TREATMENT OUTCOMES OF PATIENTS WITH LUPUS NEPHRITIS: A SINGLE CENTRE EXPERIENCE
Objective: Renal involvement in systemic lupus erythematosus (SLE), also known as lupus nephritis (LN), leads to a worse prognosis than SLE without kidney involvement.Material and Methods: Biopsy-proven LN patients diagnosed between January 2012 and January 2021 were reviewed. Complete remission (CR...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Istanbul University Press
2025-01-01
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| Series: | İstanbul Tıp Fakültesi Dergisi |
| Subjects: | |
| Online Access: | https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/09F722444B614B0C828645B7A3E249A4 |
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| Summary: | Objective: Renal involvement in systemic lupus erythematosus (SLE), also known as lupus nephritis (LN), leads to a worse prognosis than SLE without kidney involvement.Material and Methods: Biopsy-proven LN patients diagnosed between January 2012 and January 2021 were reviewed. Complete remission (CR) was defined as a reduction in the urinary protein-to-creatinine ratio (UPCR) below 0.50 g/g. Partial response is characterised by a 24-h urine protein excretion reduction to below 3 g/day with at least a 50% decrease in proteinuria. Primary effective renal response was defined as PCR of less than 0.7 g/g and the absence of any rescue therapy for treatment failure.Result: All patients exhibited proteinuria at diagnosis, with class IV LN being the most common (36.4%) form, and 65.9% had prolif erative LN. At 12 months, CR was achieved in 16 patients (37.2%) with significant differences in systolic and diastolic blood pressure and eGFR at diagnosis (p=0.01, p=0.02, and p=0.016, respective ly). CR rates were lower at 12 months in patients with proliferative LN (p=0.024) and interstitial inflammation (p=0.04). Besides, no significant difference was found in CR rates at 6 and 12 months between PLN patients treated initially with steroids and cyclo phosphamide and those treated with steroids and mycopheno late mofetil (p>0.05). However, the median time to achieve CR was shorter in the mycophenolate mofetil group (p=0.048).Conclusion: LN remains a significant source of morbidity and mortality in patients with SLE; therefore, early diagnosis and prompt initiation of the treatment are crucial for renal and patient survival. |
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| ISSN: | 1305-6441 |