title: Anti-Sm is associated with the early poor outcome of lupus nephritis.
abstract: OBJECTIVE
  We investigated whether anti-Smith (Sm) is associated with the outcome of kidney biopsy-proven lupus nephritis.
  
  
  METHODS
  We retrospectively analyzed clinical, laboratory and histological results in 90 patients with kidney biopsy-proven lupus nephritis. We defined persistent administration of immunosuppressants for more than 3 months after the kidney biopsy as early poor outcome of lupus nephritis. We compared baseline variables and delta values of lupus nephritis-related variables between patients with and without anti-Sm. The independent predictive values for early poor outcome were analyzed using logistic regression analysis.
  
  
  RESULTS
  The median age was 32.0 years old, and 77 patients (85.5%) were women. Anti-Sm was found in 44 of 90 patients (48.8%). When we analyzed the differences in delta values of variables reflecting the kidney function or the early poor outcome between patients with and without anti-Sm, we found significant difference in the early poor outcome between the two groups (80.0% of patients having anti-Sm vs. 56.5% of those not having anti-Sm, P = 0.022). In multivariate logistic regression analysis, along with age and Systemic Lupus Erythematosus Disease Activity Index, the presence of anti-Sm increased the potential of the early poor outcome of lupus nephritis (odds ratio 2.870, 95% confidence interval, 1.033, 7.976, P = 0.043).
  
  
  CONCLUSIONS
  Our data suggest that anti-Sm identified at kidney biopsy might have a predictive value for the early poor outcome of biopsy-proven lupus nephritis during the follow-up period.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Ahn
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Byung-Woo
authors.initials: BW
authors.lastname: Yoo
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Jason Jungsik
authors.initials: JJ
authors.lastname: Song
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Yong-Beom
authors.initials: YB
authors.lastname: Park
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Soo-Kon
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. sangwonlee@yuhs.ac.
authors.forename: Sang-Won
authors.initials: SW
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000187:drug effects / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology; D016015:Logistic Models; D008181:Lupus Nephritis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult; D055517:snRNP Core Proteins / Q000276:immunology*
chemical_list: D000974:Antibodies, Antinuclear; D015415:Biomarkers; D007166:Immunosuppressive Agents; D055517:snRNP Core Proteins
keywords: anti-Sm; immunosuppressants; lupus nephritis; outcome