Renal outcome and predictors of clinical renal involvement in patients with silent lupus nephritis.
OBJECTIVE
We investigated the development of clinically overt nephritis in patients with silent lupus nephritis in an effort to determine predictors of onset.


METHODS
We selected 31 patients with systemic lupus erythematosus (SLE) who were diagnosed as having silent lupus nephritis between 1985 and 1995. Urinalysis, blood cell count, serum creatinine, complement levels, and anti-double-stranded DNA antibody (anti-dsDNA antibody) levels were followed retrospectively for at least 60 months in each patient.


RESULTS
During the follow-up period, 8 patients developed clinical renal disease and 23 had no renal impairment. The mean time of overt nephritis onset was 58 months and renal function deteriorated mildly in 3 patients. Although clinical and laboratory findings were not significantly different at SLE onset, patients with overt nephritis showed both persistent elevation of anti-dsDNA antibodies and persistently low levels of serum C3 and CH50 for at least 24 months before the onset of overt nephritis.


CONCLUSIONS
Although the renal prognosis was relatively favorable, 25.8% of patients developed overt nephritis during the follow-up period. Elevation of anti-dsDNA antibodies with hypocomplementemia was persisted in these patients, suggesting the utility of these factors as predictors of clinical renal involvement in silent lupus nephritis.
Wada
Yoko
Y
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. youko.wada@ryumachi-jp.com
Ito
Satoshi
S
Ueno
Mitsuhiro
M
Nakano
Masaaki
M
Arakawa
Masaaki
M
Gejyo
Fumitake
F
D000293:Adolescent; D000328:Adult; D000974:Antibodies, Antinuclear / Q000032:analysis; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008181:Lupus Nephritis / Q000145:classification / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies
D000974:Antibodies, Antinuclear