BACKGROUND AND OBJECTIVES: The value of a complete remission in severe lupus nephritis is well known but little is known about the impact of a partial remission in this patient population. The purpose of this study was to evaluate the long-term prognosis of achieving a complete or partial remission in a well-defined group of patients with severe lupus nephritis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this study, 86 patients with diffuse lupus glomerulonephritis were reviewed for assessment of the value of a partial remission (50% reduction in baseline proteinuria to < or =1.5 g/d and < or =25% increase in baseline creatinine) and complete remission (proteinuria < or =0.33 g/d and serum creatinine < or =1.4 mg/dl) on outcomes compared with patients who did not attain a remission. These well-characterized patients were entered into a prospective therapeutic trial conducted by the Collaborative Study Group and were followed for more than 10 yr. RESULTS: All biopsies showed diffuse lupus nephritis. A complete remission was attained in 37 (43%) patients, a partial remission in 21 (24%) patients, and no remission in 28 (32%) patients. Baseline clinical and serologic features were similar among the groups, but patients with a complete remission had a lower serum creatinine and chronicity index compared with patients with partial or no remission. The patient survival at 10 yr was 95% for complete remission, 76% for partial remission, and 46% for no remission. The renal survival at 10 yr was 94% for complete remission, 45% for partial remission, and 19% for no remission, and the patient survival without end-stage renal disease at 10 yr was 92% for complete remission, 43% for partial remission, and 13% for no remission. CONCLUSION: Even a partial remission in lupus nephritis is associated with a significantly better patient and renal survival compared with no remission.
BACKGROUND AND OBJECTIVES: The value of a complete remission in severe lupus nephritis is well known but little is known about the impact of a partial remission in this patient population. The purpose of this study was to evaluate the long-term prognosis of achieving a complete or partial remission in a well-defined group of patients with severe lupus nephritis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this study, 86 patients with diffuse lupus glomerulonephritis were reviewed for assessment of the value of a partial remission (50% reduction in baseline proteinuria to < or =1.5 g/d and < or =25% increase in baseline creatinine) and complete remission (proteinuria < or =0.33 g/d and serum creatinine < or =1.4 mg/dl) on outcomes compared with patients who did not attain a remission. These well-characterized patients were entered into a prospective therapeutic trial conducted by the Collaborative Study Group and were followed for more than 10 yr. RESULTS: All biopsies showed diffuse lupus nephritis. A complete remission was attained in 37 (43%) patients, a partial remission in 21 (24%) patients, and no remission in 28 (32%) patients. Baseline clinical and serologic features were similar among the groups, but patients with a complete remission had a lower serum creatinine and chronicity index compared with patients with partial or no remission. The patient survival at 10 yr was 95% for complete remission, 76% for partial remission, and 46% for no remission. The renal survival at 10 yr was 94% for complete remission, 45% for partial remission, and 19% for no remission, and the patient survival without end-stage renal disease at 10 yr was 92% for complete remission, 43% for partial remission, and 13% for no remission. CONCLUSION: Even a partial remission in lupus nephritis is associated with a significantly better patient and renal survival compared with no remission.
Authors: Stéphan Troyanov; Catherine A Wall; Judith A Miller; James W Scholey; Daniel C Cattran Journal: J Am Soc Nephrol Date: 2005-02-16 Impact factor: 10.121
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Authors: M F Gourley; H A Austin; D Scott; C H Yarboro; E M Vaughan; J Muir; D T Boumpas; J H Klippel; J E Balow; A D Steinberg Journal: Ann Intern Med Date: 1996-10-01 Impact factor: 25.391
Authors: Mariana Cardenas-Gonzalez; Anand Srivastava; Mira Pavkovic; Vanesa Bijol; Helmut G Rennke; Isaac E Stillman; Xiaolan Zhang; Samir Parikh; Brad H Rovin; Maryam Afkarian; Ian H de Boer; Jonathan Himmelfarb; Sushrut S Waikar; Vishal S Vaidya Journal: Clin Chem Date: 2017-06-30 Impact factor: 8.327
Authors: Sushrut S Waikar; Casey M Rebholz; Zihe Zheng; Shelley Hurwitz; Chi-Yuan Hsu; Harold I Feldman; Dawei Xie; Kathleen D Liu; Theodore E Mifflin; John H Eckfeldt; Paul L Kimmel; Ramachandran S Vasan; Joseph V Bonventre; Lesley A Inker; Josef Coresh Journal: Am J Kidney Dis Date: 2018-07-18 Impact factor: 8.860
Authors: Maria I Danila; Guillermo J Pons-Estel; Jie Zhang; Luis M Vilá; John D Reveille; Graciela S Alarcón Journal: Rheumatology (Oxford) Date: 2009-02-20 Impact factor: 7.580
Authors: Peter M Izmirly; Laura Barisoni; Jill P Buyon; Mimi Y Kim; Tania L Rivera; Julie S Schwartzman; Joseph M Weisstuch; David T Liu; Stephen Bernstein; Chung-E Tseng; Howard M Belmont; Charles T Esmon; Joan T Merrill; Anca D Askanase; David B Thomas; Robert M Clancy Journal: Rheumatology (Oxford) Date: 2009-03-13 Impact factor: 7.580