Abstract
Background: The mortality rate is higher in SLE patients with lupus nephritis (LN) than in those without nephropathy. Objectives: The aim of this study was to identify the factors affecting the long-term renal outcome in 102 patients with LN. Methods: This was a retrospective cohort study. Logistic regression analysis was used in a model to determine how independent variables predicted the outcome. The survival analysis was based on the Kaplan-Meier curve with subjects censored for death. Results: The 15-year survival rate was 93.5%, and the renal function non-deterioration rate was 78.3%. No influence of individual types of immunosuppressant drugs used was found on the renal function deterioration rate. In this study, the results of analysis identified only daily urinary protein excretion level as having any significant effect on the risk of progression of LN to renal failure. Conclusions: These results suggest that remission induction therapy and maintenance therapy focused on long-term preservation of renal function need to be selected for LN patients with a high daily urinary protein value at the start of treatment and for LN patients who fail to show any reduction of the daily urinary protein excretion level to 0.5 g or less at one year after the biopsy.
Highlights
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease with diverse manifestations and the kidney is a major target organ of SLE [1] [2]
The results of analysis identified only daily urinary protein excretion level as having any significant effect on the risk of progression of lupus nephritis (LN) to renal failure. These results suggest that remission induction therapy and maintenance therapy focused on long-term preservation of renal function need to be selected for LN patients with a high daily urinary protein value at the start of treatment and for LN patients who fail to show any reduction of the daily urinary protein excretion level to 0.5 g or less at one year after the biopsy
The mortality rate is higher in SLE patients with LN than in those without nephropathy, and about 10% of patients with LN eventually show progression to end-stage renal disease (ESRD) [6] [7]
Summary
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease with diverse manifestations and the kidney is a major target organ of SLE [1] [2]. The mortality rate is higher in SLE patients with LN than in those without nephropathy, and about 10% of patients with LN eventually show progression to end-stage renal disease (ESRD) [6] [7]. Objectives: The aim of this study was to identify the factors affecting the long-term renal outcome in 102 patients with LN. Conclusions: These results suggest that remission induction therapy and maintenance therapy focused on long-term preservation of renal function need to be selected for LN patients with a high daily urinary protein value at the start of treatment and for LN patients who fail to show any reduction of the daily urinary protein excretion level to 0.5 g or less at one year after the biopsy
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