A 50% or greater reduction in proteinuria after six months of treatment for severe lupus nephritis (SLN) predicts favorable outcomes, investigators reported online in Nephrology Dialysis Transplantation.
Stephen M. Korbet, MD, of Rush University Medical Center in Chicago, and collaborators studied 61 patients who originally participated in a prospective, controlled trial comparing standard therapy with plasmapheresis for SLN. Of these, 34 patients attained a 50% or greater reduction in proteinuria at six months and 27 did not. The two groups had a similar mean follow-up period: 133 and 136 months, respectively.
At follow-up, a complete remission (CR)—defined as a serum creatinine level of 1.4 mg/dL or less and proteinuria of 0.33 g/day or less—was attained in 56% of patients who had a 50% or greater reduction in proteinuria at six months compared with 22% of the patients who did not. The 15-year renal survival was 71% and 25%, respectively, and patient survival without end-stage renal disease was 66% and 18%, respectively. All the differences between the groups were statistically significant.