Response to treatment as a predictor of longterm outcome in patients with lupus nephritis.
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.


CONCLUSIONS
Response of proteinuria to treatment over one year is a useful predictor of longterm outcomes in lupus nephritis.
Fraenkel
L
L
Division of Rheumatology, Montreal General Hospital, McGill University, PQ, Canada.
MacKenzie
T
T
Joseph
L
L
Kashgarian
M
M
Hayslett
J P
JP
Esdaile
J M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007668:Kidney / Q000473:pathology; D008181:Lupus Nephritis / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011507:Proteinuria / Q000652:urine*; D015996:Survival Rate; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D003404:Creatinine