title: Lupus nephritis: a 15-year multi-centre experience in the UK.
abstract: OBJECTIVE
  Our aim was to audit the outcome of lupus nephritis (LN) at three East Midlands centres.
  
  
  METHODS
  We undertook a retrospective review of all biopsy-proven LN types III-V 1995-2010.
  
  
  RESULTS
  In total, 61 patients with LN were identified, with a median follow-up of 68 months. LN was present at the time of systemic lupus erythematosus (SLE) diagnosis in 20 patients. The median time from SLE diagnosis to the first LN episode was 5.3 years. Some 35 patients received IV cyclophosphamide and 17 received mycophenolate mofetil (MMF) as induction therapy; 81.8% of those treated with cyclophosphamide and 81.3% with MMF had at least 'improved' according to the ACR-response criteria 6 months from induction; 33.3% and 37.5%, respectively, had a 'complete' response. MMF and azathioprine were the most frequently used maintenance therapy. We found that 32.8% experienced a flare after a mean post-induction time of 3.5 years, irrespective of the maintenance therapy used, and 43.8% of partial responders flared compared with 4.8% of complete responders. End-stage renal failure developed in 8.2%.
  
  
  CONCLUSIONS
  Overall, outcomes (response, flare-rate, end-stage renal failure) were comparable with European clinical studies. Partial responders are more likely to flare compared with complete responders. The results highlight that LN can occur, and flare, after many years of SLE, emphasizing the importance of continued vigilance for LN in all patients.
authors: Department of Rheumatology, Nottingham University Hospitals NHS Trust, UK. mhui@nhs.net
authors: M
authors: M
authors: Hui
authors: R
authors: R
authors: Garner
authors: F
authors: F
authors: Rees
authors: R
authors: R
authors: Bavakunji
authors: P
authors: P
authors: Daniel
authors: S
authors: S
authors: Varughese
authors: A
authors: A
authors: Srikanth
authors: M
authors: M
authors: Andres
authors: F
authors: F
authors: Pearce
authors: J
authors: J
authors: Leung
authors: K
authors: K
authors: Lim
authors: M
authors: M
authors: Regan
authors: P
authors: P
authors: Lanyon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008181:Lupus Nephritis / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D012189:Retrospective Studies; D006113:United Kingdom; D055815:Young Adult