Abstract: FR-PO1107
Outcomes of Pure Membranous Lupus Nephritis in an Urban Predominantly African-American Patient Population
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
- Kenny Thomas, Jeffy, Emory University , Atlanta, Georgia, United States
- Alqudsi, Muhannad, Emory University , Atlanta, Georgia, United States
- Baig, Furheen, Emory University , Atlanta, Georgia, United States
- Hoge, Courtney E., Emory University , Atlanta, Georgia, United States
- Lim, Sung S., Emory University , Atlanta, Georgia, United States
- Cobb, Jason, Emory University School of Medicine, Atlanta, Georgia, United States
Group or Team Name
- Emory Nephrology
Background
Treatment options for pure membranous (class V) lupus nephritis (LN) include prednisone, cyclophosphamide (CYC), calcineurin inhibitors (CNI), and mycophenolate mofetil (MMF). There is a paucity of data on the use of MMF; a pooled analysis from studies for the treatment of proliferative LN have compared MMF to CYC for the treatment of pure membranous LN. We are comparing the outcomes of pure membranous LN patients treated with MMF in comparison to other therapies in our urban predominantly African-American patient population.
Methods
Kidney biopsy log from 2010 – 2017, and a retrospective chart review was completed. We excluded any patients with proliferative disease (active or chronic). We analyzed data (t-test comparison) comparing LN class V patients treated with MMF in comparison to other therapies.
Results
There was 101 patients with pure membranous LN and 54 patients with sufficient follow-up data were included. Induction regimens: MMF (n=29) and (n=25) other therapies (6=CYC, 3=CNI, 12=prednisone alone, 3=azathioprine, 1=ARB alone). Racial demographics: 51=black race (94%), 1=Hispanic, 1=white, 1=native Hawaiian. 52 female patients. Average follow-up 3.5 years. MMF treated group: initial serum creatinine (Scr) - 0.85 mg/dL, initial serum albumin (Salb) 2.67 g/dL, and initial urine protein/creatinine ratio (UPC) of 4.14 mg/g. Other therapies group: initial Scr – 1.58 g/dL, initial Salb 2.53 g/dL, and initial UPC of 4.32 mg/g. MMF treated: final Scr – 0.89 mg/dL, final Salb 3.30 g/dL, and final UPC 1.39 mg/g. Other therapies: final Scr – 1.53 mg/dL, final Salb 3.55 g/dL, and final UPC of 0.70 mg/g. There was no difference in percent with abnormal C3, C4, or dsDNA. At baseline Scr was 1.58 mg/dL (other group) vs. 0.85 mg/dL (MMF group) p <.05, and at final Scr 1.53 mg/dL (other group) vs. 0.89 mg/dL (MMF) p =.08.
Conclusion
In our predominantly African-American patient population MMF is effective as other therapies for Class V LN. There was a significant difference in initial Scr between the MMF and other therapies group, and the difference remained throughout. There was a greater than 50% reduction in UPC in both groups. The study displayed a good prognosis in both groups at the end of treatment.