ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO1104

A Nationwide Analysis of Outcomes of Adult Lupus Nephritis in Japan

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Hiromura, Keiju, Gunma University Graduate School of Medicine, Maebashi, Japan
  • Ikeuchi, Hidekazu, Gunma University Graduate School of Medicine, Maebashi, Japan
  • Sugiyama, Hitoshi, Okayama University Graduate School Medicine, Okayama, Japan
  • Sato, Hiroshi, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
  • Yokoyama, Hitoshi, Kanazawa Medical University, Ishikawa, Japan
  • Nojima, Yoshihisa, Japan Red Cross Maebashi Hospital, Maebashi, Japan

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.