title: Long-term outcome of biopsy-proven lupus nephritis in Iran.
abstract: BACKGROUND
  This study was conducted to evaluate the survival of patients with lupus nephritis (LN) in two different lupus clinics in Iran.
  
  
  METHODS
  This was a retrospective cohort study covering 82 patients diagnosed with biopsy-proven LN hospitalized between 1994 until 2010. Demographic, clinical, laboratory, therapeutic and end-point data were collected. Renal biopsies were categorized according to the 2004 classification of the International Society of Nephrology/Renal Pathology Society (ISN/RPS). Survival plots, univariate and multivariate Cox regression analyses were applied.
  
  
  RESULTS
  Female/male ratio was 65/17. Mortality rate was 6.1% (five patients). Fifty-five (67%), 18 (22%), and four (4.9%) patients had complete/partial remission, chronic renal failure (CRF) and end-stage renal disease (ESRD), respectively. Renal biopsies showed 0, three (3.7%), 18 (22%), 58 (70.7%), two (2.4%) and 0 patients with ISN/RPS classes I, II, III, IV, V and VI, respectively, and one patient (1.2%) with mixed class (IV and V). The 5, 10 and 15 year survival rates for living patients were 97%, 92% and 69%, respectively. When CRF, ESRD and death were considered as one category of poor patient outcome, the 5, 10 and 15 year survival rates for remission were 87%, 47% and 35%, respectively. Multivariate analysis demonstrated the following independent protectives against poor outcome: class II nephritis (hazards ratio [HR] = 0.67; 95% confidence interval [CI], 0.57-0.85), class III nephritis (HR = 0.002; 95% CI, 0-0.036) and time passed since SLE diagnosis (HR = 0.006; 95% CI, 0-0.1).
  
  
  CONCLUSIONS
  Survival rates of Iranian patients with LN were comparable with those of developed countries.
authors.affiliation: Department of Rheumatology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Alimohammad
authors.initials: A
authors.lastname: Fatemi
authors.forename: Mehdi
authors.initials: M
authors.lastname: Kazemi
authors.forename: Zahra
authors.initials: Z
authors.lastname: Sayedbonakdar
authors.forename: Ziba
authors.initials: Z
authors.lastname: Farajzadegan
authors.forename: Hadi
authors.initials: H
authors.lastname: Karimzadeh
authors.forename: Mahdi
authors.initials: M
authors.lastname: Moosavi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D016009:Chi-Square Distribution; D003906:Developing Countries; D018450:Disease Progression; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality / Q000473:pathology; D008181:Lupus Nephritis / Q000150:complications* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Iran; lupus nephritis; outcome