Contribution of renal biopsy data in predicting outcome in lupus nephritis: analysis of 116 patients

Authors

  • Hans C. Nossent MD,

    Corresponding author
    1. Department of Rheumatology, Dr. Daniel den Hoed Clinic
    2. Departments of Rheumatology and Pathology, Dr. Daniel den Hoed Clinic, Rotterdam; the Department of Pathology, Slotervaart Hospital, Amsterdam; the Department of Nephrology, St. Radboud Hospital, University of Nijmegen, The Netherlands.
    • Department of Rheumatology, Dr. Daniel den Hoed Clinic, PO Box 5201, Rotterdam 3008 AE, The Netherlands
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  • Sonja C. Henzen-Logmans MD, PhD,

    1. Department of Pathology, Dr. Daniel den Hoed Clinic
    2. Departments of Rheumatology and Pathology, Dr. Daniel den Hoed Clinic, Rotterdam; the Department of Pathology, Slotervaart Hospital, Amsterdam; the Department of Nephrology, St. Radboud Hospital, University of Nijmegen, The Netherlands.
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  • Thea M. Vroom MD, PhD,

    1. Department of Pathology, Slotervaart Hospital, Dr. Daniel den Hoed Clinic
    2. Departments of Rheumatology and Pathology, Dr. Daniel den Hoed Clinic, Rotterdam; the Department of Pathology, Slotervaart Hospital, Amsterdam; the Department of Nephrology, St. Radboud Hospital, University of Nijmegen, The Netherlands.
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  • Jo H. M. Berden MD, PhD,

    1. Department of Nephrology, St. Radboud Hospital, University of Nijmegen
    2. Departments of Rheumatology and Pathology, Dr. Daniel den Hoed Clinic, Rotterdam; the Department of Pathology, Slotervaart Hospital, Amsterdam; the Department of Nephrology, St. Radboud Hospital, University of Nijmegen, The Netherlands.
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  • Tom J. G. Swaak MD, PhD

    1. Department of Rheumatology, Dr. Daniel den Hoed Clinic
    2. Departments of Rheumatology and Pathology, Dr. Daniel den Hoed Clinic, Rotterdam; the Department of Pathology, Slotervaart Hospital, Amsterdam; the Department of Nephrology, St. Radboud Hospital, University of Nijmegen, The Netherlands.
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Abstract

We reassessed renal biopsy specimens from 116 patients with systemic lupus erythematosus and clinical manifestations of lupus nephritis to determine the contributions of the World Health Organization classification system, the activity and chronicity indexes of the National Institutes of Health scoring system, and various clinical parameters at the time of biopsy to predicting disease outcome. Multivariate analysis showed that only a chronicity index >3 was predictive for decreased renal survival, while age >31 years at biopsy and a chronicity index >3 were associated with decreased patient survival. Clinical tests of renal function were not reliable in discriminating between active lesions and chronic renal damage.

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