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High rate of histological transformation at long-term follow-up associated with lupus nephritis diagnosis
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Recently published results showed a high rate of histological transformation at long-term follow-up among patients diagnosed with lupus nephritis class II.
Researchers recorded creatinine, urine sediment and proteinuria in 41 patients diagnosed with lupus nephritis class II at the time of first biopsy, as well as at 6 months, 1 year, 2 years and 5 years after the first biopsy. Researchers evaluated response to treatment, histological transformation and long-term outcomes.
Results showed 28 patients had manifestation of proteinuria greater than 0.5 g per day, 18 patients had hematuria and three patients had deterioration of renal function at first biopsy. Researchers performed a new biopsy in 18 patients during follow-up and found histological transformation in 17 patients. Compared with all patients who did not undergo a second biopsy, researchers noted 10 of 18 patients who underwent a second biopsy were on hydroxychloroquine.
Of the data available on 34 patients 1 year after the first renal biopsy, results showed 24 patients achieved response vs. 10 patients who had no response. According to results, predictors of worse outcome at 1 year included a higher 24-hour urinary protein at 6 months. Researchers found patients in the nonresponder group had a statistically significant difference for worse outcomes at 1 years vs. patients in the responder group. At 5-year follow-up, the main cause of unfavorable outcome was histological transformation, according to results, which researchers measured in 11 of 14 patients. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.
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