Original InvestigationFactors predictive of outcome in severe lupus nephritis
Section snippets
Patients
The 86 adult patients participating in the prospective controlled trial of plasmapheresis in severe lupus nephritis conducted from April 1981 to December 1988 comprise the study group. In this retrospective study, we extended the mean follow-up to 120 months. Because there were no significant differences between the two treatment groups during the therapeutic trial, patient data are pooled for the purpose of this follow-up study.
Entry criteria, therapeutic and medical management protocols, and
Clinical renal remission
Clinical remission occurred in 37 of the 86 patients (43%) with severe lupus nephritis during the initial 5 years of the study. The average time to remission was 16 ± 14 months (median, 10.5 months). Baseline features of the 86 patients and comparisons based on remission status are listed in Tables 1 through 3, and features were similar between the two groups with respect to age, sex, and level of proteinuria (Table 1).
Empty Cell All Remission No Remission P * No. of
Discussion
Our experience shows that the induction of clinical remission of renal dysfunction is predictive of improved long-term prognosis in patient and renal survival, even for patients with the most severe forms of lupus nephritis. These findings agree with retrospective analyses by Appel et al17, 18 and Fraenkel et al,2 who also found that marked regression or remission of clinical renal disease predicted a favorable long-term prognosis in patients with lupus nephritis.
Evidence for the likelihood of
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Received August 31, 1999; accepted in revised form December 3, 1999.
Address reprint requests to Stephen M. Korbet, MD, Section of Nephrology, Rush-Presbyterian–St Lukes Medical Center, 1653 W Congress Pkwy, Chicago, IL 60612.