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Official publication of the Indian Society of Nephrology
 
ORIGINAL ARTICLE
Ahead of Print

Long-term outcome of lupus nephritis: A single center study


 Department of Nephrology, St. Johns Medical College, Bangalore, Karnataka, India

Correspondence Address:
S Renuka,
Professor of Nephrology, St. Johns Medical College, Sarjapur Road, Opp BDA Complex, Bengaluru - 560 034, Karnataka
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_25_20

Introduction: There is paucity of data on long-term outcome of lupus nephritis (LN) from south India. Our study looks at long term outcomes in patients with biopsy proven LN with terms of response to therapy, flare, mortality, treatment-related complications, outcome and post flare analysis. We also analyzed the factors which predicted the outcome. Methods: A retrospective observational study was conducted from 2005 to 2012 at St. John's Medical college and hospital, Bangalore. Patients received treatment as per NIH protocol. Patients of LN who regularly visited OPD were included. Statistical analysis was done by using SPSS 19 software. Results: At end of 84 ± 6 months (N = 59), 38 subjects showed complete remission (CR), 6 partial remission (PR), 3 developed chronic kidney disease, 2 developed end-stage kidney disease (ESKD), and 10 died. In outcome of flare (N = 15), 7 had nephrotic flare, 3 had refractory flare, 3 showed nephritic flare with 2 developing ESKD. Change of LN class was 3 subjects had changed to class II from class IV, 1 to class II from class V, 7 to class III from class IV, 2 to class IV from class V, and 2 to class IV from class VI. Factors predicting poor outcomes were serum creatinine, hypertension at presentation, and failure to achieve remission in 1 year. 7 subjects conceived, of which 4 of them were treated with azathioprine (AZA) and 3 of them who were on mycophenolate mofetil and was changed to AZA. 4 subjects had successful pregnancy outcome, 2 had preeclampsia, and 1 subject had missed abortion. Conclusion: At end of 84 ± 6 months, patient survival rate was 84%.


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    -  Limesh M
    -  Kedlaya PG
    -  Renuka S
    -  Vinod N
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Indian Journal of Nephrology
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