Abstract: FR-PO738

Concordance of Clinical and Histological Response on Lupus Nephritis Patients

Session Information

Category: Glomerular

  • 1004 Clinical/Diagnostic Renal Pathology and Lab Medicine

Authors

  • Aguirre Campos, Diana Angelica, Hospital General Dr. Miguel Silva, Morelia, Mexico
  • Arellano, Jesus, Hospital General Dr. Miguel Silva, Morelia, Mexico
  • Navarro escamilla, Adolfo, Hospital General Dr. Miguel Silva, Morelia, Mexico
  • Martinez-Chagolla, Blanca, Hospital General Dr. Miguel Silva, Morelia, Mexico
  • Mariscal, Luis A., Hospital General Dr. Miguel Silva, Morelia, Mexico
Background

Renal response in lupus nephritis usually exclude the renal histology component. There are discordance between clinical findings and the histological activity. Recent studies has suggested that repeat biopsy after induction therapy may be useful to evaluate response to immunosuppressive therapy. The objective was to compare the concordance between clinical and histological response on proliferative lupus nephritis patients.

Methods

This retrospective study included patients between June 2010 and May 2017 with proliferative lupus nephritis who had a control biopsy after induction treatment. We evaluate complete clinical response (CCR), partial clinical response (PCR) and no clinical response (NCR) according to ACR criteria. The histological response (HR) was defined as an activity index less or equal to 3 in the control biopsy. For concordance analysis we evaluate by 2 criteria: the first (CR1) defined as Non Responders the patients with PCR and NRC. The second criteria (CR2) take as Non responders only the NRC patients. Concordance was evaluated by Kappa coefficient.

Results

We included 19 patients, 7 of them with lupus flare; 15 women (78.9%); mean age 27.4±5.79 years old and follow-up of 384±116 days. The control biopsy was performed between 6 to 12 months after the start of the treatment. At control biopsy 5 patients (26.31%) had CCR, 5 (26.31%) PCR and 9 (47.36%) NCR. Twelve patients (63.1%) had histological response and 7 (36.8%) without histological response. The concordance between clinical and histological response was 0.53 in the CR1 criteria, and 0.47 in the CR2 criteria.

Conclusion

The study show a low concordance between clinical and histological response in proliferative lupus nephritis.