Long-term outcome of biopsy-proven lupus nephritis in Iran.

This study was conducted to evaluate the survival of patients with lupus nephritis (LN) in two different lupus clinics in Iran. 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. 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). Survival rates of Iranian patients with LN were comparable with those of developed countries.

Fatemi A ，Kazemi M ，Sayedbonakdar Z ，Farajzadegan Z ，Karimzadeh H ，Moosavi M ... -  《-》

Outcome of lupus nephritis in childhood onset SLE in North and Central India: single-centre experience over 25 years.

Childhood SLE (cSLE) has a higher prevalence of lupus nephritis (LN), and there are ethnic variations in response to treatment as well as outcome of LN. There are limited data on long-term outcome of LN in cSLE from the Indian subcontinent. Retrospective analysis of case records of patients with cSLE (satisfying revised American College of Rheumatology (ACR) 1997 criteria for diagnosis) and age of onset <18 years was conducted from 1989 to 2013. Data on clinical features, renal involvement and biopsy findings, treatment, renal outcome, damage accrual and mortality were collected. End-stage renal disease (ESRD) was defined as the need for renal replacement therapy. Actuarial ESRD-free survival was studied as the primary outcome measure using Kaplan-Meier analysis. Among 205 children with cSLE, 134 (121 girls) had evidence of LN. The mean age at disease onset was 13.7 ± 3.5 years and the mean disease duration at presentation was 1.9 ± 2.5 years. Kidney biopsy was available for 92 patients, and histology included: 13 (14.2%) Class II, 24 (26%) Class III, 43 (46.7%) Class IV and 12 (13.1%) Class V LN. The mean follow-up period was 6.75 ± 5.7 years. At last visit, 81 (60.4%) children were in complete remission, 28 (20.9%) were in partial remission, 15 (11.2%) still had active nephritis and 10 (7.4%) had progressed to ESRD. Almost two-thirds (62.9%) of patients experienced lupus flares, and mean flare rate was 0.09 flares/patient follow-up year. Fifty-six (43.8%) children accrued damage and the mean Systemic Lupus International Collaborating Clinics (SLICC)/ACR damage score was 0.79 ± 1.13. Actuarial ESRD-free survival at five, 10 and 15 years was 91.1%, 79% and 76.2%, and five-, 10- and 15-year renal survival was 93.8%, 87.1% and 84%, respectively. Although multiple factors individually predicted poor outcome (death/ESRD), only raised serum creatinine at onset (R square = 0.65, p ≤ 0.0001) and damage accrual (R square = 0.62, p ≤ 0.0001) remained significant on multivariate analysis. Eleven (8.2%) children died during the follow-up period, and infections were the leading cause of mortality. Long-term outcome of LN in cSLE in our cohort was better than previous reports from India. However, a high rate of major infection still remains the leading cause of mortality.

Srivastava P ，Abujam B ，Misra R ，Lawrence A ，Agarwal V ，Aggarwal A ... -  《-》

Renal Remission Status and Longterm Renal Survival in Patients with Lupus Nephritis: A Retrospective Cohort Analysis.

Davidson JE ，Fu Q ，Ji B ，Rao S ，Roth D ，Magder LS ，Petri M ... -  《-》

Predictors of end-stage renal disease and recurrence of lupus activity after initiation of dialysis in patients with lupus nephritis.

Moon SJ ，Park HS ，Kwok SK ，Ju JH ，Kim HY ，Park SH ... -  《CLINICAL AND EXPERIMENTAL RHEUMATOLOGY》

Combination immunosuppressant therapy and lupus nephritis outcome: a hospital-based study.

Chen YM ，Hung WT ，Liao YW ，Hsu CY ，Hsieh TY ，Chen HH ，Hsieh CW ，Lin CT ，Lai KL ，Tang KT ，Tseng CW ，Huang WN ，Chen YH ... -  《-》