Abstract: FR-PO892
Calcineurin Inhibitors May Prevent Diffuse Membranous Lesions In Lupus Nephritis
Session Information
- Glomerular Diseases: Membranous Nephropathy, SLE, Complement
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1203 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Ikuma, Daisuke, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
- Mizuno, Hiroki, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
- Yamanouchi, Masayuki, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
- Hoshino, Junichi, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
- Takaichi, Kenmei, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
- Ubara, Yoshifumi, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
Background
Lupus nephritis (LN) is a relapsing disease. The pathologic features of LN may change with relapse, and such changes cannot definitely be predicted clinically. Current guidelines recommend selecting treatment for LN according to the 2003 ISN/RPS classification, which states that glucocorticoids (GC) are the key drugs. Little is known about whether or not other immunosuppressants are effective for LN, including cyclophosphamide, mycophenolate mofetil, azathioprine, and calcineurin inhibitors (CNI). In class V LN, accumulation of subepithelial immune complexes leads to glomerular inflammation. CNI have been reported to show a podocyte-protecting effect that is independent of their immunosuppressive activity. Accordingly, we examined the effect of CNI on class V lesions in patients with relapsing LN.
Methods
Forty-six Japanese patients with LN, who underwent one or more repeat renal biopsies at our hospital between May 1995 and May 2017, were analyzed retrospectively. Patients who received continuous administration of CNI were assigned to the CNI group and other patients were assigned to the non-CNI group.
Results
There were 25 patients in the CNI group and 21 patients in the non-CNI group. No significant differences of baseline characteristics were noted between the two groups. In the CNI group, the number of patients with class V lesions decreased from 13/25 (52%) at baseline to 9/25 (36%) at the time of re-biopsy. On the other hand, the number of patients with class V lesions increased from 6/19 (31.6%) at baseline to 14/21 (66.7%) at re-biopsy in the non-CNI group. We investigated risk factors for relapse of LN with class V lesions by performing multiple logistic regression analysis, and found that CNI use was a negative risk factor with an odds ratio (95% confidence interval) of 0.211 (0.0531-0.839).
Conclusion
CNI may prevent the relapse of LN with class V lesions.