PMID- 33822705 OWN - NLM STAT- MEDLINE DCOM- 20220131 LR - 20220405 IS - 0392-856X (Print) IS - 0392-856X (Linking) VI - 40 IP - 1 DP - 2022 Jan TI - Predictors of renal flares and long-term renal outcome in patients with lupus nephritis: results from daily clinical practice. PG - 33-38 LID - 10.55563/clinexprheumatol/c58c39 [doi] AB - OBJECTIVES: To describe renal outcomes of the lupus nephritis (LN) population of the University Medical Centre Groningen (UMCG) in the Netherlands and to identify predictors for renal flares and long-term renal outcome in daily clinical practice. METHODS: A retrospective analysis of biopsy-proven LN patients with induction and maintenance treatment in the UMCG between 1982 and 2016 was performed. Data were collected at time of diagnosis, after 6 months and every year up to 10 years after diagnosis. Outcome measures were renal relapse (biopsy proven), progression to chronic kidney disease (CKD) stage 3 or 4 and chronic renal replacement therapy. The ability of serum creatinine, proteinuria, creatinine clearance, serum anti-double stranded DNA (anti-dsDNA) antibodies, serum complement 3 (C3) and serum complement 4 (C4), as well as biographic data and histopathological class to predict long-term renal outcome was assessed. RESULTS: Seventy-one patients were included, with median follow-up of 120 months (IQR 48-120 months). During follow-up - up to 10 years - twenty-one (30%) patients experienced at least one relapse. Eleven (15%) patients had CKD stage 3 or 4, of whom eight showed persistent CKD since baseline and two (3%) patients required chronic renal replacement therapy. At baseline, low levels of serum C3 were a significant predictor of renal relapse. Low levels of C3 and C4 at 6 and 12 and proteinuria and high levels of anti-dsDNA at 12 months were significant predictors of renal relapse. At baseline, 6 months and 12 months serum creatinine and creatinine clearance were significant predictors for persistent or newly developed CKD 3 or 4, and need for chronic renal replacement therapy. CONCLUSIONS: Almost one-third of LN patients experience at least one renal relapse during long-term follow up, but only 3% need chronic renal replacement therapy. Our data suggests that early serological remission is associated with a low risk of renal relapse. Decreased renal function at onset and the first year after diagnosis is predictive for decreased renal function at a later stage. FAU - Ligtenberg, Gijs AU - Ligtenberg G AD - Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, The Netherlands. FAU - Arends, Suzanne AU - Arends S AD - Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, The Netherlands. FAU - Stegeman, Coen A AU - Stegeman CA AD - Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, The Netherlands. FAU - de Leeuw, Karina AU - de Leeuw K AD - Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, The Netherlands. k.de.leeuw@umcg.nl. LA - eng PT - Journal Article DEP - 20210330 PL - Italy TA - Clin Exp Rheumatol JT - Clinical and experimental rheumatology JID - 8308521 RN - 0 (Complement C4) RN - 0 (Immunosuppressive Agents) RN - AYI8EX34EU (Creatinine) SB - IM MH - Complement C4 MH - Creatinine MH - Humans MH - Immunosuppressive Agents MH - Kidney/physiology MH - *Lupus Nephritis/diagnosis/drug therapy MH - Retrospective Studies EDAT- 2021/04/07 06:00 MHDA- 2022/02/01 06:00 CRDT- 2021/04/06 17:16 PHST- 2020/09/25 00:00 [received] PHST- 2020/12/14 00:00 [accepted] PHST- 2021/04/07 06:00 [pubmed] PHST- 2022/02/01 06:00 [medline] PHST- 2021/04/06 17:16 [entrez] AID - 16486 [pii] AID - 10.55563/clinexprheumatol/c58c39 [doi] PST - ppublish SO - Clin Exp Rheumatol. 2022 Jan;40(1):33-38. doi: 10.55563/clinexprheumatol/c58c39. Epub 2021 Mar 30.