Background and aims To report the long-term renal outcome of a cohort of Saudi children with systemic lupus erythematosus (SLE)

Methods All patients with childhood lupus nephritis (cLN) proved by renal biopsy seen between January 2000 and June 2015 were reviewed The renal outcome was assessed according to serum creatinine level, protein/creatinine ratio at the last follow-up visit, and/or evidence of renal impairment during follow-up period and end stage renal disease (ESRD). Additional outcome measures include accrual damage measured by pSDI and death related to SLE was determined.

Results A total of 84 (72 females) cLN patients with follow-up duration of 9.3 years were included. The mean current age was 19.4 years and mean age at onset was 9.2 years. The most frequent histological class was proliferative glomerulonephritis (64.3%) followed by membranous nephritis (27.4%). The mean activity and chronicity were 6 and 4 respectively. Renal microthrombosis was found in 9 (10.7%) patients. All patients treated with immunosuppressive medications; cyclophosphamide used in 64 followed by mycophenolate mofetil in 42 while rituximab used in 24 patients. At last follow up visit, the mean serum creatinine was 147 and the mean protein/creatinine ratio was 0.8 while the mean total SDI was 1.89. Sixteen (19%) patients had ESRD. However, there was no significant difference in ESRD by histological class. The overall survival rates were 5 years: 94% and 10 years: 87%. Infection was the leading cause of mortality.

Conclusions Our patients had severe cLN and required intensive treatment. However, the survival rate is comparable to other studies.