Original InvestigationClinical and prognostic value of serial renal biopsies in lupus nephritis
Section snippets
Methods
Thirty-one Italian patients with lupus nephritis followed up by two nephrology units (Ospedale Malpighi, Bologna; Ospedale Maggiore, Milano, Italy) between January 1965 and January 1997 participated on this study. The inclusion criteria were: (1) diagnosis of systemic lupus erythematosus according to the revised American Rheumatism Diagnostic Criteria,18 (2) urine protein excretion of more than 1 g/d and/or elevated plasma creatinine level at presentation, and (3) renal biopsy performed at the
Clinical characteristics at first renal biopsy
Of the 31 patients with lupus nephritis who entered onto the study, 26 were women and 5 were men. At admission, the median age was 23 years (25th and 75th percentile, 18 and 31), and the median duration of lupus nephritis was 3 months (25th and 75th percentile, 0 and 10.5). Fifteen patients had elevated plasma creatinine levels (median, 2.2 mg/dL; 25th and 75th percentile, 1.5 and 4.9), whereas the other 16 patients had a plasma creatinine level between 0.5 and 1.1 mg/dL. The median proteinuria
Discussion
There are few reports on serial renal biopsies in patients with lupus nephritis. Most of those studies showed a transformation from one histological class to another in 26% to 50% of repeated renal biopsy.13, 15, 17, 24, 25, 26, 27, 28 However, little attention was given to the prognostic significance of repeated biopsy. Balow et al29 evaluated the variations of chronicity index in patients assigned to different therapeutic regimens. Patients treated with prednisone alone showed a significant
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Received December 28, 1998; accepted in revised form March 26, 1999.
Address reprint requests to Gabriella Moroni, MD, Divisione di Nefrologia e Dialisi, Istituto Scientifico Ospedale Maggiore Policlinico, Via Commenda, 15, 20122 Milano, Italy. E-mail: [email protected]