CHICAGO—Certain features at the time of renal biopsy are associated with a particular class of lupus nephritis (LN) and may independently predict good renal outcomes, according to a new Canadian study presented at the 2011 American College of Rheumatology Annual Scientific Meeting.
“In our updated analysis, we found that SDI [SLE damage index] scores of zero at the time of biopsy and lower 24-hour proteinuria were associated with complete renal remission at six months, and higher non-renal SLEDAI [SLE disease activity index] at baseline and lower chronicity index on renal biopsy were associated with complete renal remission at one year post biopsy,” said lead investigator Claire Barber, MD, a rheumatologist at the University of Calgary in Alberta, Canada.
Dr. Barber and her colleagues studied a large prospectively followed cohort of patients with systemic lupus erythematosus (SLE) at a single center with renal biopsy slides available and matched clinical follow-up. Investigators collected demographic and clinical data at time of renal biopsy. Renal biopsies were reviewed by two expert pathologists independently and by a third pathologist in cases of disagreement to determine a consensus score. The degree of agreement between pathologists on individual items of the ISN/RPS score was measured. The goal of this investigation was to examine the clinical-pathological correlates at time of renal biopsy in LN patients according to the 2003 International Society of Nephrology and Renal Pathology Society (ISN/RPS) classification.
“The ISN-RPS classification of lupus nephritis was developed in 2003 and was designed to improve the prognostic significance of biopsy findings compared to the WHO classification. We undertook this study as there continue to be conflicting reports in the literature regarding the clinical correlates and long-term outcomes associated with the different classes of lupus nephritis based on the ISN/RPS classification,” Dr. Barber said.