Clinicopathological correlations and prognostic factors in lupus nephritis.
OBJECTIVE
To define prognostic factors at the moment of the diagnosis in lupus nephritis, and to assess the contribution of renal histologic data.


METHODS
Sixty-two patients with systemic lupus erythematosus (SLE) and histologic evidence of nephritis were studied for renal outcome. Correlations between clinical or biological and histological data were carried out as an indicator of the utility of the renal biopsy.


RESULTS
There were no significant differences in creatinine between the different histologic classes at the moment of the diagnosis, although the WHO classification correlated well with proteinuria and immunologic activity. There was a strong correlation between clinical and histological activity as measured by the activity index in proliferative glomerulonephritis, mainly with creatinine and proteinuria, but not with haematuria or immunological activity. Young age at the time of renal biopsy, proliferative classes III and IV, and the chronicity index were associated with a poorer renal prognosis.


CONCLUSIONS
High immunologic activity, mainly elevated anti-DNA titers and decreased levels of CH100, is highly suggestive of proliferative glomerulonephritis. Proliferative classes III and IV and high chronicity indexes are associated with a worse prognosis in lupus nephritis.
Mitjavila
F
F
Department of Internal Medicine, Ciutat Sanitària i Universitària de Bellvitge, Barcelona, Spain.
Pac
V
V
Moga
I
I
Poveda
R
R
Vidaller
A
A
Carrera
M
M
Pujol
R
R
D000293:Adolescent; D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D001706:Biopsy; D003404:Creatinine / Q000097:blood; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D006417:Hematuria / Q000175:diagnosis; D006801:Humans; D006818:Hyalin; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D008181:Lupus Nephritis / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011507:Proteinuria / Q000175:diagnosis; D013927:Thrombosis / Q000473:pathology
D000974:Antibodies, Antinuclear; D016682:Lupus Coagulation Inhibitor; D003404:Creatinine