Lupus nephritis is one of the most severe Systemic Lupus
Erythematosus features, defining treatment modality and prognosis. Our
retrospective study, including 178 patients treated for lupus nephritis during
23 years with mostly cyclophosphamide-based initial regimens followed by
azathioprine or mycophenolic acid, demonstrates 84.8% of renal response with
19.2% of flares, 15-year patient survival 78.7% and kidney survival 76.3%, and
low damage accrual. Both patient and kidney survival significantly differ for
subgroups that achieved complete or partial renal response and nonresponders:
patient 15-year survival 95% versus 65% versus 35%; kidney 15-year survival
100% versus 58% versus 0%, respectively. 51% (24 out of 47) of patients
evaluated at the end of the study period sustained complete renal response;
however, only 9 of them had 0 disease activity according to SELENA SLEDAI
scale, while 13 patients had scores 2–4 due to the serological abnormalities
only. We conclude that (1) initial treatment with cyclophosphamide followed by
azathioprine is effective and can be used in agreement with International
Guidelines until the evidence for biological treatments benefits becomes
available; (2) complete and even partial renal response have positive
prognostic value, and failure to achieve renal response negatively influences
kidney and patient survival; (3) the validity of complete renal response in SLE
is questioned by the absence of conventional definition of SLE remission.
Author(s) Details Dr. Elena V. Zakharova
Department of Nephrology, City Botkin Memorial Hospital, Moscow, Russia and Department of Nephrology, State University of Medicine and Dentistry, Moscow, Russia
Dr. Tatiana A. Makarova
Department of Nephrology, City Botkin Memorial Hospital, Moscow, Russia.
Dr. Elena V. Zvonova
Department of Nephrology, City Botkin Memorial Hospital, Moscow, Russia.
Dr. Alina M. Anilina
Department of Nephrology, City Botkin Memorial Hospital, Moscow, Russia.
Dr. Ekaterina S. Stolyarevich
Department of Nephrology, State University of Medicine and Dentistry, Moscow, Russia.
View Book :- http://bp.bookpi.org/index.php/bpi/catalog/book/190
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