Background and aims To determine: 1-the predictive ability of proteinuria, urinary sediment (uRBCs) and serum creatinine (Cr) at 1 year to predict good long-term outcomes, and 2- the best proteinuria cut-off at 1 year to predict good long-term outcomes.
Methods Retrospective analysis on 1849 patients. Patients with lupus nephritis (LN) (24 hour proteinuria [24H-P]>0.5 g/d) with at least 7 years’ follow-up were identified and baseline was defined as the onset of LN. Good renal outcome was defined as Cr <100 mmol/L and renal transplant/dialysis-free at 7 years.
ROC curves examined the predictive power of Cr, 24H-P, and uRBCs at 1 year post-LN diagnosis with respect to good renal outcome. AUC were analysed for: a) 24H-P at year 1, b) absolute change in 24H-P between year 1 and 7, and c) percent change in 24H-P between year 1 and 7. The proteinuria cutoff was identified by optimising sensitivity/specificity.
Results 101 LN patients were analysed with baseline 24H-P of 2.36±2.31 g/d. 24H-P of 0.6 g/d at 1 year after LN diagnosis best predicted good long-term renal outcome, with sensitivity 62%/specificity 70% (Figure 1).
AUC analysis confirmed that 24H-P at 1 year, but not absolute/percent change, is a predictor of good long-term renal outcomes (Figures 1 and 2). uRBCs did not provide any predictive benefit while Cr at 1 year predicted long-term renal outcome with an AUC of 0.82 (Figure 2).
Conclusions Proteinuria of 0.6 g/d at 1 year and Cr at 1 year post-LN diagnosis best predicted good long-term renal outcome. uRBCs did not offer any prognostic benefit.
- © 2017, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.