Kidney Week

Abstract: SA-PO242

Improvement of Prognosis of Lupus Nephritis in Recent Years: A Single Center Retrospective Study

Session Information

• Clinical Glomerular Disorders: Vasculitis, C3G, IgAN
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Glomerular

• 1005 Clinical Glomerular Disorders

Authors

• Suwa, Junya, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

Junya Suwa,

• Ikeuchi, Hidekazu, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

Hidekazu Ikeuchi,

• Nakasatomi, Masao, Japan Red Cross Maebashi Hospital, Maebashi, Gunma, Japan

Masao Nakasatomi,

• Sakairi, Toru, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

Toru Sakairi,

• Kaneko, Yoriaki, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

Yoriaki Kaneko,

• Maeshima, Akito, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

Akito Maeshima,

• Nojima, Yoshihisa, Japan Red Cross Maebashi Hospital, Maebashi, Gunma, Japan

Yoshihisa Nojima,

• Hiromura, Keiju, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

Keiju Hiromura,

Background

The treatment of SLE has been changing year by year, but it is not clear how the change actually relates to the improvement of the prognosis.

Methods

The treatment of lupus nephritis (LN) has been changing. In the present study, we examined the change of prognosis of LN in our facility.

Results

Median age was 34 years (IQR 28-47), median observation period was 105 months (IQR 47-189). ISN/RPS Class was follows: III(±V), 35 pts; IV(±V) 82 pts; pure V, 23 pts. The prognosis was significantly better in patients after 2000 in both renal events + patient death or renal events alone (P=0.0196 and P<0.001, respectively, Figure). In addition, frequency of proteinuric remission was significantly better in patients after 2000 at both of 6 months and 12 months after treatment (43.1% vs 68.9%, P<0.001; 60.7% vs. 78.7%, P= 0.031; respectively). There was no significant difference in levels of SCr and complements, and frequency of anti-DNA antibodies at baseline. Regarding the treatments, frequencies of steroid pulse therapy and dose of prednisolone were not different between the 2 groups, However, frequencies of immunosuppressants for the first induction therapy were different between before and after 2000: p.o. cyclophosphamide, 45.0% vs 3.3%, P<0.01; tacrolimus, 0.0% vs 11.2%, P=0.014; mycophenolate mofetil + tacrolimus, 0.0% vs 23.5%, P<0.01.

Conclusion

In our facility, the prognosis of active LN has been improved in recent years. The changes of immunosuppressants might contribute to better proteinuric remission rate at 6 and 12 months after induction therapy and lead to better long-term prognosis of LN.

Left: Renal events + Patient death, Right: Renal events