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Abstract: FR-PO894

The Level of Proteinuria After 6 and 12 Months of Treatment Predicts Long-Term Renal Outcomes in Lupus Nephritis: Data from a Nationwide Cohort Study in Japan

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Ikeuchi, Hidekazu, Gunma University, Maebashi, Japan
  • Hiromura, Keiju, Gunma University, Maebashi, Japan
  • Sugiyama, Hitoshi, Okayama University, Okayama, Japan
  • Sato, Hiroshi, Tohoku University, Sendai, Japan
  • Yokoyama, Hitoshi, Kanazawa Medical University, Uchinada, Japan
  • Nojima, Yoshihisa, Inoue Hospital, Takasaki, Japan

Group or Team Name

  • On Behalf of the JSN Lupus Nephritis Study Group
Background

Recent studies of lupus nephritis in European countries (the Euro-Lupus Nephritis Trial and the MAINTAIN study) showed the level of proteinuria at 12 months is the best predictor for long-term renal outcome. The aim of this study is to evaluate urinary protein levels after treatment as a predictor of long-term renal outcomes, by analyzing data of a recent nationwide cohort study of lupus nephritis in Japan.

Methods

Among 498 lupus nephritis patients who received renal biopsy between 2007 and 2012 at 27 institutions and were registered in Japan Renal Biopsy Registry, data of 282 patients were analyzed who were treated with immunosuppressive therapies after renal biopsy and were observed more than 5 years. Poor renal outcome was defined as doubling serum creatinine (S-Cr) or end-stage renal disease (ESRD). Deterioration of renal function was defined as 1.5 times increase in S-Cr from baseline. Clinical data at the time of biopsy, 6 and 12 months after treatment were analyzed.

Results

During the median observation period of 5.3 years, 32 patient reached poor renal outcome and 68 patients showed deterioration of renal function. ROC analysis revealed that levels of urinary protein/Cr (UP/U-Cr) predicting poor renal outcomes were as follows: 1.64 g/gCr at 6 months (sensitivity 83.0%, specificity 72.7%, AUC 0.828) and 0.87 g/gCr at 12 months (sensitivity 80.0%, specificity 81.8%, AUC 0.862). Levels of UP/U-Cr predicting deterioration of renal function were as follows: 1.10 g/gCr at 6 months (sensitivity 79.5%, specificity 63.3%, AUC 0.753) and 0.49 g/gCr at 12 months (sensitivity 73.4%, specificity 71.0%, AUC 0.745).

Conclusion

Levels of proteinuria at 6 months and 12 months after the treatment are good predictors for long-term renal outcomes in a recent nationwide cohort study of lupus nephritis in Japan.