title: Predictors of mortality and end stage renal disease in Saudi patients with lupus nephritis.
abstract: The purpose of this study was to investigate the presentation and factors affecting outcome over a 9-year period in 99 consecutive Saudi patients with biopsy proven lupus nephritis (LN), 35.5% of whom had nephrotic range proteinuria, 46.8% had estimated glomerular filtration rate (eGFR) <60  ml/min/1.73  m(2) and 65.5% had histological class IV. The female:male ratio was 3.7:1. During the observation period, there were significant rises in eGFR (p = 0.005), C4 (p = 0.000) and significant decrease in 24-h urine protein (p = 0.028). No correlation was found between final eGFR and baseline 24-h protein, anti-DNA, C3 or C4. Female patients had a significantly higher rise in eGFR (p = 0.05).During follow-up (FU), 28.2% required dialysis. The survival rates at 5, 10 and 15  years were 92%, 77% and 77% respectively. Baseline C3 and C4 levels were significantly lower in the patients who died (p = 0.0001 and 0.02 respectively). Those who required dialysis were more likely to die (p < 0.000) (risk ratio = 4.46; 95% confidence interval 2.8-7.2). Hypertension at presentation was associated with lower baseline eGFR (p = 0.01) and final eGFR (p = 0.002) but did not affect the baseline proteinuria. Baseline eGFR of <60  ml/min/1.73  m(2) at presentation was associated with lower eGFR at end of FU (p = 0.000), higher activity score (p = 0.0001) and chronicity scores (p = 0.017).
authors.affiliation: Internal Medicine, Department of Medicine, King Abdulaziz Medical City, Saudi Arabia.
authors.forename: H
authors.initials: H
authors.lastname: Al Durahim
authors.forename: G
authors.initials: G
authors.lastname: Al Ghamdi
authors.forename: A
authors.initials: A
authors.lastname: Al Seraya
authors.forename: R
authors.initials: R
authors.lastname: Alkhiari
authors.forename: A
authors.initials: A
authors.lastname: Al Sayyari
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D003176:Complement C3 / Q000378:metabolism; D003181:Complement C4 / Q000378:metabolism; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000401:mortality* / Q000503:physiopathology; D008181:Lupus Nephritis / Q000150:complications* / Q000401:mortality* / Q000503:physiopathology; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000974:Antibodies, Antinuclear; D003176:Complement C3; D003181:Complement C4