title: Outcome of patients with membranous lupus nephritis in Cape Town South Africa.
abstract: BACKGROUND
  The kidney is one of the major target organs affected by systemic lupus erythematosus. Although proliferative forms of lupus nephritis (LN) occur more frequently than membranous LN (MLN), the latter appears to have a more favourable outcome. Only a few studies have reported the outcome of patients with MLN.
  
  
  METHODS
  A retrospective analysis of patients with biopsy-confirmed MLN from a single centre in South Africa treated from 1st January 2000 to 31st December 2009.
  
  
  RESULTS
  The mean age of the patients (n = 42) at onset of LN was 35.0 ± 12.8 years with 73.8% of the patients being of mixed ancestry (coloureds). Eleven patients (26.2%) reached the composite end point of death or end-stage renal disease or persistent doubling of serum creatinine. The overall median survival and median renal survival times were 82.3 ± 15.5 months (95% confidence interval 52.0-112.6) and 84.5 ± 15.0 months (55.1-113.8), respectively. Also, 5-year event-free survival and renal survival were 64 and 71%, respectively. On multivariate analysis, systolic blood pressure (BP) during follow-up (P = 0.029), diastolic BP during follow-up (P = 0.020) and attainment of complete remission at 6 months (P = 0.033) were factors associated with the composite end points. Although treatment with chloroquine was not significantly associated with the composite end points (P = 0.05), we found that patients who received chloroquine had better renal survival compared with those who did not (P = 0.007).
  
  
  CONCLUSIONS
  The outcome of patients with MLN in Cape Town is poorer than for similar patients reported from other centres across the world. Better BP control may significantly influence outcome of disease in these patients.
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa. Ikechi.Okpechi@uct.ac.za
authors.forename: Ikechi G
authors.initials: IG
authors.lastname: Okpechi
authors.forename: Olugbenga E
authors.initials: OE
authors.lastname: Ayodele
authors.forename: Erika S W
authors.initials: ES
authors.lastname: Jones
authors.forename: Maureen
authors.initials: M
authors.lastname: Duffield
authors.forename: Charles R
authors.initials: CR
authors.lastname: Swanepoel
mesh_terms: D000328:Adult; D001794:Blood Pressure; D002462:Cell Membrane / Q000473:pathology*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality*; D008181:Lupus Nephritis / Q000150:complications / Q000401:mortality* / Q000628:therapy; D008297:Male; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D013019:South Africa; D015996:Survival Rate