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O33 Per-protocol repeat kidney biopsy portends relapse and long-term outcome in incident cases of proliferative lupus nephritis
- Source :
- Oral presentations.
- Publication Year :
- 2020
- Publisher :
- Lupus Foundation of America, 2020.
-
Abstract
- Background In patients with Lupus Nephritis (LN), clinical response to treatment and renal histopathology have been shown to be discordant. We investigated whether per-protocol repeat renal biopsies are predictive of LN relapses and long-term impairment of renal function. Methods Forty-two patients with an incident biopsy-proven active proliferative (class III/IV ± V) LN from the LN database of the Universite catholique de Louvain were included in the present retrospective study. Per-protocol repeat kidney biopsies were performed in all patients after a median time of 24.3 (IQR: 21.3–26.2) months. The NIH activity index (AI) and chronicity index (CI) scores were assessed in both baseline and repeat biopsies. Results Despite a moderate correlation between urinary protein/creatinine (U-P/C) ratios and AI scores at repeat biopsy (r=0.48; P=0.001), ten patients (23.8%) with U-P/C ratios 3; figure 1). High AI scores in repeat biopsies were associated with an increased probability and/or shorter time to renal relapse (N=11) following the repeat biopsy (HR: 1.2; 95% CI: 1.1–1.3; P=0.007), independently of proteinuria levels. High NIH CI scores in repeat biopsies were associated with a sustained increase in serum creatinine levels corresponding to ≥120% of the baseline value (HR: 1.8; 95% CI: 1.1–2.9; P=0.016) through a median follow-up time of 131.5 (IQR: 73.8–178.2) months. Baseline AI/CI scores were not predictive of these outcomes. Conclusions Our results highlight the usefulness of per-protocol repeat biopsies as an integral part of the treatment evaluation, also in patients who have shown adequate clinical response.
- Subjects :
- medicine.medical_specialty
Kidney
Creatinine
Proteinuria
medicine.diagnostic_test
business.industry
Lupus nephritis
Renal function
Retrospective cohort study
medicine.disease
Response to treatment
Gastroenterology
chemistry.chemical_compound
medicine.anatomical_structure
chemistry
Internal medicine
Biopsy
medicine
medicine.symptom
business
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Oral presentations
- Accession number :
- edsair.doi...........15e1df1e8e28a13185cfb52898d1369f
- Full Text :
- https://doi.org/10.1136/lupus-2020-eurolupus.44