title: Prognostic factors for treatment response in patients with lupus nephritis.
abstract: OBJECTIVE
  To identify prognostic factors associated with response to induction therapy in lupus nephritis (LN) according to the stage of treatment.
  
  
  METHODS
  We analyzed a retrospective cohort of patients of systemic lupus erythematosus (SLE) with biopsy-proven LN from January 2001 to December 2008. LN was classified according to WHO. All patients received induction therapy and had a minimum follow-up period of two years. We analyzed 18 clinical and laboratory variables that potentially have predictive value for response to therapy. We identified predictors of therapeutic response at 6, 12 and 24 months by univariate and multivariate analysis; odds ratios (OR) with confidence intervals (CI) 95% were also calculated.
  
  
  RESULTS
  We reviewed the clinical records of 168 patients, 141 female (84%). The response rate was 69% at 6 months, 86.9% at 12 months and 79.7% at 24 months. Multivariate analysis found that > 25 years of age at diagnosis of LN and the presence of microhematuria were factors associated with good response to induction treatment. At 12 months, baseline creatinine clearance < 30ml/min was associated with a poor response to treatment. Finally at 24 months, delay in treatment was a predictor of poor response to treatment and the presence of a histological proliferative NL and low C3 were associated with good response to treatment.
  
  
  CONCLUSIONS
  There are treatment-modifiable factors that can alter aberrant immunologic activity of NF. Therefore, intensive early treatment of lupus nephritis is associated with favorable response to two years.
authors.affiliation: Departamento de Reumatología, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, México D.F., México.
authors.forename: Dafhne
authors.initials: D
authors.lastname: Miranda-Hernández
authors.affiliation: Departamento de Reumatología, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, México D.F., México.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cruz-Reyes
authors.affiliation: Dirección de Epidemiología, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, México D.F., México.
authors.forename: Ulises
authors.initials: U
authors.lastname: Angeles
authors.affiliation: Dirección de Educación e Investigación, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, México D.F., México; Universidad Nacional Autónoma de México, México D.F., México.
authors.forename: Luis Javier
authors.initials: LJ
authors.lastname: Jara
authors.affiliation: Departamento de Reumatología, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, México D.F., México; Universidad Nacional Autónoma de México, México D.F., México. Electronic address: miansaavsa@gmail.com.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Saavedra
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008181:Lupus Nephritis / Q000188:drug therapy*; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies
keywords: Factores pronósticos; Lupus eritematoso sistémico; Lupus nephritis; Nefritis lúpica; Prognostic factors; Systemic lupus erythematosus; Tratamiento; Treatment