[A clinical study of renal hemodynamics in patients with lupus nephritis].
This study was designed to evaluate the clinical significance of glomerular filtration rate (GFR) and renal plasma flow (RPF) in 122 patients with lupus nephritis. All patients had definite clinical evidence of active lupus nephritis, including urinary and immunological abnormalities. The average RPF was 634.5 +/- 171.4 ml/min in systemic lupus erythematosus patients and 537.4 +/- 141.9 ml/min in 37 age-and sex-matched patients with primary glomerular disease (PGD) (p < 0.01). A fall in GFR, accompanied by massive proteinuria and hypocomplementemia, was observed frequently in patients with class IV lupus nephritis (diffuse proliferative GN). In contrast, RPF did not change in most patients except in some with increased RPF. No correlation was noticed between RPF and proteinuria or immunological abnormalities. As a result, a marked fall in filtration fraction (FF) was observed frequently in class IV lupus nephritis, and was correlated significantly with urinary and immunological abnormalities. Follow-up data during treatment in the active to inactive phases (average 7.8 months) were available for 39 patients. The average GFR increased significantly from 56.9 +/- 31.4 ml/min in the pre-treatment stage to 74.5 +/- 26.9 ml/min in the post-treatment stage, accompanied by an improvement in proteinuria and hypocomplementemia. On the other hand, RPF decreased significantly from 521.3 +/- 217.1 to 437.6 +/- 156.2 ml/min, so that FF increased significantly as the renal and immunological parameters normalized. Additionally, the renal function was evaluated in 11 patients during the exacerbation of lupus nephritis.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Medicine (II), Niigata University School of Medicine.
M
M
Nakano
H
H
Hasegawa
T
T
Watanabe
T
T
Kuroda
S
S
Ito
T
T
Saeki
M
M
Ueno
T
T
Ozawa
M
M
Kikuchi
T
T
Sato
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D008181:Lupus Nephritis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012079:Renal Circulation; D012720:Severity of Illness Index