Predictors of Good Long-Term Renal Outcomes in Lupus Nephritis: Results from a Single Lupus Cohort

Abstract EN

This study aims to elucidate the predictive capabilities of proteinuria, serum creatinine (Cr), and urine RBCs (uRBCs) with respect to long-term renal outcomes in lupus nephritis (LN) in patients followed in clinic.

Methods.

A retrospective analysis was performed on patients with LN.

We evaluated the ability of proteinuria, serum Cr, and uRBCs at 12 months to predict good long-term renal outcomes defined as serum Cr ≤ 100 mmol/L and kidney transplant/dialysis-free at the 7th year.

Receiver operator characteristic curves were generated for proteinuria, serum Cr, and uRBCs to study their ability to predict good long-term outcomes and to identify their best cut-off.

Descriptive statistics studied the pattern of change of proteinuria and serum Cr.

Results.

Proteinuria of 0.6 g/d and Cr of 83 mmol/L performed independently moderately well in predicting good long-term renal outcomes while uRBC was less accurate.

Combining serum Cr to proteinuria gave a small increase in positive predictive value with a trade-off in sensitivity.

Proteinuria changed within the first year whereas serum Cr changed until the 7th year.

Conclusions.

Both proteinuria and Cr predict good long-term renal outcomes in LN.

Proteinuria’s ability to change faster at 12 months makes it a favorable endpoint for clinical trials and research studies.