title: Early achievement of complete renal response predicts good long-term renal outcome and low systemic damage in newly diagnosed lupus nephritis class III or IV.
abstract: OBJECTIVE
  To identify predictors of long-term renal prognosis after induction therapy in patients with newly diagnosed lupus nephritis class III or IV.
  
  
  METHODS
  We retrospectively studied patients with newly diagnosed lupus nephritis class III or IV. We divided them into two groups according to the complete renal response (CR) status at 3 years after induction therapy. We compared baseline clinical characteristics, renal pathological findings, and time to achieve CR, and identified predictors. Patients were followed up for to 10 years to assess long-term systemic damage.
  
  
  RESULTS
  Eighteen patients with CR and 9 with non-CR were included. There were no significant differences in baseline characteristics. Early CR, which was defined as achieving CR at 3 months after induction therapy, was significantly associated with maintaining CR at 3 years (p = 0.012). Patients with early CR less frequently had flare in systemic manifestation compared with those without over 10 years (p = 0.026). Deterioration of systemic damage was observed more often in non-early CR patients than early CR patients at 10 years (p = 0.029).
  
  
  CONCLUSIONS
  Achieving CR at 3 months after induction therapy may predict CR at 3 years, reduced organ damage, and a low incidence of disease flare for 10 years.
authors.affiliation: a Division of Rheumatology, Department of Internal Medicine , Keio University School of Medicine , Tokyo , Japan.
authors.forename: Hironari
authors.initials: H
authors.lastname: Hanaoka
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Masataka
authors.initials: M
authors.lastname: Kuwana
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takeuchi
mesh_terms: D000328:Adult; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008181:Lupus Nephritis / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids
keywords: Early complete renal response; Lupus nephritis; Systemic lupus erythematosus