Short-term renal parameters predicted long-term lupus outcomes

WASHINGTON — A hazard index tool based on short-term renal parameters predicted long-term outcomes in patients with lupus nephritis, according to data presented at the American College of Rheumatology Annual Meeting.

“The goal of our project was to examine the associations between short-term renal parameters and long-term outcomes to establish novel end points that might be used in lupus nephritis trials and can predict long-term kidney health,” Meggan Mackay, MD, in the Division of Autoimmune & Musculoskeletal Disorders at the Feinstein Institute for Medical Research in New York, said in a presentation.

Mackay and colleagues assessed a database of 558 patients with lupus nephritis flares at baseline. Of the 558 patients, there were 75 chronic kidney disease (CKD) events and follow-up ranged from 22 months to 317 months. The database included 12 multinational clinical centers and three clinical trials. At 12 months, the researchers assessed the ability of certain clinical parameters to predict the development of CKD, which they defined as a 30% sustained decrease in the estimated glomerular filtration rate (eGFR). The researchers assessed the following parameters:

red blood cells (RBCs) in the urine;
age;
black or non-black race;
International Society of Nephrology (ISN) class;
serum creatinine (SCr) levels; and
proteinuria.

The researchers found that CKD was associated with percent change in proteinuria (hazard ratio = 1.86), SCr (hazard ratio = 5.11) and race (hazard ratio = 1.65). However, urine RBCs did not predict CKD. The researchers created a weighted hazard index formula to predict CKD development based on the predictive parameters.

The researchers concluded that this tool can be used in clinical trials that evaluate new lupus drugs in preventing CKD.

“This has a lot of potential application for clinical trials,” Mackay said. – by Will Offit

Reference:

Mackay M, et al. Abstract #967. Presented at: American College of Rheumatology Annual Meeting; Nov. 11-16, 2016; Washington.

Disclosures: Mackay reports no relevant financial disclosures. Please see the abstract for all other authors’ disclosures.