@article {Tamiroue000123, author = {Farah Tamirou and Bernard R Lauwerys and Maria Dall{\textquoteright}Era and Meggan Mackay and Brad Rovin and Ricard Cervera and Fr{\'e}d{\'e}ric A Houssiau}, editor = {, and Abramowicz, Daniel and de Bruxelles, Libre and Atzeni, Fabiola and Blockmans, Daniel and Danieli, Maria Giovanna and De Clercq, Luc and D{\textquoteright}Cruz, David and Guttierez, Maria del Mar Ayala and Garrido, Enrique de Ramon and Gilboe, Inge-Magrethe and de Keyser, Filip and Delahousse, Michel and Espinosa, Gerard and Fiehn, Christoph and Golstein, Marc and Guillevin, Lo{\"\i}c and Hirsch, Marco and Karras, Alexandre and Lang, Philippe and le Guern, V{\'e}ronique and Marchal, Martine and Marinho, Antonio and Max, Regina and Peeters, Patrick and Petera, Peter and Petrovic, Radmila and Qu{\'e}meneur, Thomas and Raeman, Frank and Remy, Philippe and Ravelingien, Isabelle and Sarzi-Puttini, Piercarlo and Sangle, Shirish and Tektonidou, Maria and de Santis, Lucia Valiente and Vasconcelos, Carlos and Verresen, Luc and Weiss, Laurence and Westhovens, Ren{\'e}}, title = {A proteinuria cut-off level of 0.7 g/day after 12 months of treatment best predicts long-term renal outcome in lupus nephritis: data from the MAINTAIN Nephritis Trial}, volume = {2}, number = {1}, elocation-id = {e000123}, year = {2015}, doi = {10.1136/lupus-2015-000123}, publisher = {Archives of Disease in childhood}, abstract = {Background Although an early decrease in proteinuria has been correlated with good long-term renal outcome in lupus nephritis (LN), studies aimed at defining a cut-off proteinuria value are missing, except a recent analysis performed on patients randomised in the Euro-Lupus Nephritis Trial, demonstrating that a target value of 0.8 g/day at month 12 optimised sensitivity and specificity for the prediction of good renal outcome. The objective of the current work is to validate this target in another LN study, namely the MAINTAIN Nephritis Trial (MNT).Methods Long-term (at least 7 years) renal function data were available for 90 patients randomised in the MNT. Receiver operating characteristic curves were built to test the performance of proteinuria measured within the 1st year as short-term predictor of long-term renal outcome. We calculated the positive and negative predictive values (PPV, NPV).Results After 12 months of treatment, achievement of a proteinuria \<0.7 g/day best predicted good renal outcome, with a sensitivity and a specificity of 71\% and 75\%, respectively. The PPV was high (94\%) but the NPV low (29\%). Addition of the requirement of urine red blood cells <=5/hpf as response criteria at month 12 reduced sensitivity from 71\% to 41\%.Conclusions In this cohort of mainly Caucasian patients suffering from a first episode of LN in most cases, achievement of a proteinuria \<0.7 g/day at month 12 best predicts good outcome at 7 years and inclusion of haematuria in the set of criteria at month 12 undermines the sensitivity of early proteinuria decrease for the prediction of good outcome. The robustness of these conclusions stems from the very similar results obtained in two distinct LN cohorts.Trial registration number: NCT00204022.}, URL = {https://lupus.bmj.com/content/2/1/e000123}, eprint = {https://lupus.bmj.com/content/2/1/e000123.full.pdf}, journal = {Lupus Science \& Medicine} }