Predictors of Remission in Lupus Nephritis Pati

El-Shebiney, Emad Mohamed; Zahran, Enas Sobhy; Abd EL-Hamid, Alaa Efat; Abdelatty, Eman Hamdi; Tharwat, Samar

doi:10.21608/ejhm.2021.171397

Predictors of Remission in Lupus Nephritis Pati

Document Type : Original Article

Authors

¹ Clinical Immunology and Rheumatology Unit, Internal Medicine Department, Menoufia University, Egypt

² Hematology and BMT Unit, Internal Medicine Department, Menoufia University, Egypt

³ Nephrology and Dialysis Unit, Ahmad Maher Teaching Hospital

⁴ Rheumatology and Immunology Unit, Internal Medicine Department, Mansoura University, Egypt

10.21608/ejhm.2021.171397

Abstract

Background: Lupus nephritis (LN) is a common and serious manifestation of SLE, occurring in more than half of patients with SLE during their course of illness, in 10–25% of such patients, kidney disorder progresses to end-stage renal disease (ESRD).
Objective: To determine the predictors of remission in patients with biopsy-proven lupus nephritis, and to assess the long-term renal remission rate in our lupus nephritis patients.
Patients and Methods: This is a retrospective observational study carried out at the Rheumatology and Nephrology Units, Internal Medicine Department, Menoufia and Mansoura Universities Hospitals, Egypt for a 1-year duration between 1 June 2019 and 1 June 2020. A total of 60 patients with biopsy-proven LN were studied.
Results: In the current study, after six months of follow-up, about two-thirds of patients achieved remission. The urinary protein creatinine ratio (UPCR) of 4.9 g/g, systemic lupus erythematosus disease activity index (SLEDAI) of 20 and Hb of 8.8 g/dl at the third month are valuable for predicting remission at the sixth month in active lupus nephritis. On multivariate analysis, serum creatinine (SCr) at the time of diagnosis is the only independent predictor of remission (complete or partial) at 6 months. According to the receiver operating characteristic curve, the cut-off value of SCr ≤ 2.9 mg/dL with 100% specificity and 98 % sensitivity was a predictor for renal remission.
Conclusion:The UPCR of 4.9 g/g, SLEDAI of 20 and Hb of 8.8 g/dl at the third month are valuable for predicting remission at the sixth month in active lupus nephritis. Serum creatinine level ≤2.9 mg/dL at the time of diagnosis was the only independent predictor of complete remission at 6 months.

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