Abstract: TH-PO834
Histologic vs Clinical Remission in Proliferative Lupus Nephritis at 6 Months - An Experience from a State Run Tertiary Care Centre in Southern India
Session Information
- Glomerular Diseases: Immunology and Inflammation - I
October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1202 Glomerular Diseases: Immunology and Inflammation
Author
- L, Umesh, Institute of nephrourology, Bangalore, India
Background
Aim and objective of this study is to describe the renal histology of the second biopsy and correlate histopathological remission with clinical remission at 6 months.
Methods
The study conducted in Department of Nephrology, Institute of Nephro-Urology, Victoria Hospital Campus Bangalore, India between Oct 2015 and Nov 2017. A total of 50 consecutive patients with biopsy proven Proliferative Lupus Nephritis were included in the study. Clinical response was defined as complete (CRR), partial (PRR) or non-response (NRR) according to recent definitions. Histological response (HR) was defined as Class I, II or III/IV-C on repeat biopsies.
Results
1/3 rd cases who were achieved complete remission clinically failed to achieve histological remission. Out of 19 patients 12(63%) had transformation to favorable class in CRR group. Out of 19 patients 12(63%) in PPR group and out of 12 patients 8(66%) in NRR group had unfavorable class at 6 months. Though Chronicity Index increased in all clinical subgroups, non responders had statistically significant increased CI.
Conclusion
The protocol renal biopsies performed at six months demonstrated an increase in chronicity, especially within the same histological class. 1/3rd patients with complete remission group had active lesions at the end of induction treatment, questioning the current induction therapy of 6 months which may not be sufficient. More RCTs are needed to test whether repeated biopsies should be considered as a part of the evaluation of treatment response in LN.