J Rheum Dis.  2022 Oct;29(4):223-231. 10.4078/jrd.22.0006.

Predictive Factors for Renal Response in Lupus Nephritis: A Single-center Prospective Cohort Study

• Park DJ
• Joo YB
• Bang SY
• Lee J
• Lee HS
• Bae SC

• KMID: 2533623
• DOI: http://doi.org/10.4078/jrd.22.0006

Abstract

Objective
To identify the predictive factors for renal response in patients with lupus nephritis (LN).
Methods
Patients and data were extracted from a prospective systemic lupus erythematosus cohort in Korea, in which clinical data were collected at 0, 3, 6, and 12 months after induction therapy. Treatment response of LN were evaluated as a complete response (CR), partial response (PR), or non-response (NR) at 3, 6, and 12 months, respectively. Predictive factors for CR at 6 months were evaluated using multivariable Poisson regression analysis.
Results
A total of 75 patients with LN who underwent biopsy was enrolled. The mean age at diagnosis of LN was 28.9±9.7 years, and 68 (90.7%) were female. The frequencies of classes III, IV, III+V, IV+V, and V were 20.0%, 44.0%, 16.0%, 12.0%, and 8.0%, respectively. Compared to relapsed LN, new-onset LN showed a lower percentage of glomerulosclerosis (45.5% vs. 76.2%, p=0.013). The overall proportions of CR, PR, and NR at 6 and 12 months were 52.0%, 26.7%, 21.3% and 50.7%, 24.0%, 25.3%, respectively. In multivariate analysis, age at enrollment (odds ratio [OR]=1.02, p=0.022), relapsed LN (OR=0.71, p=0.037), anti-Ro antibody (OR=0.67, p=0.014), and class III LN (OR=1.48, p=0.001) were associated with CR at 6 months.
Conclusion
In our prospective cohort, class III LN was a good predictive factor for CR at 6 months in patients with LN, whereas younger age, relapsed LN, and anti-Ro antibody were poor predictive factors.

Keyword

Systemic lupus erythematosus; Lupus nephritis; Outcome assessment; Risk factor

Figure

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  Fig. 1 Comparison of renal response rates at 3, 6, and 12 months after induction treatment (A). Comparison of renal response rates by lupus nephritis class at 3, 6, and 12 months (B).

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