Kidney Week

Abstract: FR-PO1104

A Nationwide Analysis of Outcomes of Adult Lupus Nephritis in Japan

Session Information

• Glomerular Diseases: Clinical, Outcomes, Trials - II
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

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

Keiju Hiromura,

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

Hidekazu Ikeuchi,

• Sugiyama, Hitoshi, Okayama University Graduate School Medicine, Okayama, Japan

Hitoshi Sugiyama,

• Sato, Hiroshi, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan

Hiroshi Sato,

• Yokoyama, Hitoshi, Kanazawa Medical University, Ishikawa, Japan

Hitoshi Yokoyama,

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

Yoshihisa Nojima,

Group or Team Name

• JSN Lupus Nephritis Study Group

Background

Although the prognosis of lupus nephritis (LN) has been improved, some patients reached end-stage renal disease (ESRD). We aimed to examine recent prognosis of LN in Japan using nation-wide registry.

Methods

This study is a retrospective cohort study. Adult patients (18 years old or older) who were registered as LN in Japan Renal Biopsy Registry (J-RBR) between 2007 and 2012 were examined. Primary endpoint was defined as doubling serum creatinine (S-Cr) or ESRD requiring renal replacement therapy. Data were expressed as median (IQR).

Results

498 patients (88 male), age 39 (30-52) years-old, from 27 institutions were evaluated. New-onset of LN, 348 patients; relapse, 106 patients; refractory, 35 patients; others, 9 patients. Clinical data at the renal biopsy were as follows: eGFR 78.3 (56.3-100.8) ml/min/1.73m², urinary protein 2.04 (0.87-4.30) g/gCr. 40.0% of patients had nephrotic syndrome and 12.2% of patients showed rapidly progressive glomerulonephritis clinically. The frequency of each ISN/RPS Class was as follows: I, 1.6%; II, 5.8%; III, 26.9%; IV, 46.6%; V, 18.5%; VI, 0.6%. During the observation period of 63 (49-82) months, 36 patients (7.2%) reached primary endpoints, 75 patients (15.1%) reached 1.5 times increase in S-Cr or ESRD, and 27 patients (5.4%) died. Renal survival (not doubling S-Cr or ESRD) curve in each Class was calculated by Kaplan-Meier analysis and shown in Figure 1. The 5-year renal survival and 5-year patient survival was 94.0% and 94.8% in total patients, and 92.1% and 93.1% even in Class IV, respectively. Among patients with new-onset LN (n=348), the 5-year renal survival and 5-year patient survival was 94.8% and 94.2% in total patients, and 93.1% and 92.4% in Class IV, respectively.

Conclusion

Recent prognosis of LN are relatively good at least 5 years after renal biopsy in real-world clinical practice in Japan.

Funding

• Government Support - Non-U.S.