FRI0176 NON-HISTOLOGIC FACTORS DISCRIMINATING PROLIFERATIVE LUPUS NEPHRITIS FROM MEMBRANOUS LUPUS NEPHRITIS

Abstract

Background:The treatment strategy and renal prognosis between proliferative lupus nephritis (LN) and membranous LN are different. Therefore, it is important to distinguish one from the other. To date, data regarding non-histologic factors that can discriminate proliferative LN from membranous LN are limited.Objectives:To investigate non-histologic factors that can discriminate proliferative LN from membranous LN in patients with systemic lupus erythematosus with renal manifestations.Methods:Patients with biopsy-proven proliferative LN and membranous LN were included. Non-histologic factors were compared between the two groups. A logistic regression analysis was performed to identify the factors associated with proliferative LN. To assess the accuracy of these factors in discriminating between proliferative LN and membranous LN, we performed a receiver-operating characteristic analysis.Results:Of the total 168 patients with biopsy-proven LN, 150 patients (89.3%) had proliferative LN, and 18 patients (10.7%) had membranous LN. In the multivariable logistic regression analysis, positive anti-double-stranded DNA (anti-dsDNA) antibody (adjusted OR = 11.200, 95% CI = 2.202–56.957, p = 0.004) was associated with proliferative LN, while positive anti-U1RNP antibody (adjusted OR = 0.176, 95% CI = 0.040–0.769, p = 0.021) and higher glomerular filtration rate (GFR) (adjusted OR = 0.973, 95% CI = 0.951–0.994, p = 0.013) were inversely associated with proliferative LN. Among these covariates, the anti-dsDNA antibody (area under the curve = 0.806, 95% CI = 0.695–0.916) had the highest accuracy in discriminating between proliferative LN and membranous LN.Conclusion:The positivity of anti-dsDNA antibody was associated with proliferative LN, while the positivity of anti-U1RNP antibody and GFR were inversely associated with proliferative LN. The anti-dsDNA antibody had a good accuracy in discriminating proliferative LN from membranous LN.