Clinical research studyLong-term Outcome of Diffuse Proliferative Lupus Glomerulonephritis Treated with Cyclophosphamide
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Study Population
Between 1988 and 2002, all patients with renal biopsy-proven diffuse proliferative lupus glomerulonephritis (Class IV nephritis according to the revised 1995 WHO classification15) treated in 5 regional hospitals of Hong Kong were identified from either the hospital clinical registries or the pathologists’ renal biopsy databases. All patients had to fulfill at least 4 of the American College of Rheumatology (ACR) criteria for the classification of SLE.9 Those patients who were treated initially
Demographic Data and Baseline Renal Parameters
A total of 268 patients with diffuse proliferative lupus nephritis confirmed by renal biopsy were identified. Two hundred twelve patients (188 women, 24 men) were initially treated with prednisolone and CYC. All were ethnic Chinese. The mean age was 30.9 ± 10.9 years, and the mean SLE duration was 36.7 ± 55.1 months. At the time of renal biopsy, 70% of patients were nephrotic, 37% had impaired serum creatinine level (>106 umol/L), and 34% were hypertensive (blood pressure ≥140/90 mmHg). The
Discussion
This is a retrospective review of the long-term outcome of a very large cohort of patients with DPLN treated initially with prednisolone and CYC and followed prospectively in 5 regional hospitals of Hong Kong. As CYC protocols being used and the monitoring strategies for patients are similar in these centers, longitudinal data are available for analysis. Using the hospital clinical and pathology registries, we believe that we have nested all the patients within the specified period to minimize
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