Predictive Factors for Renal Response in Lupus Nephritis: A Single-center Prospective Cohort Study

Dae Jin Park; Young Bin Joo; So-Young Bang; Jiyoung Lee; Hye-Soon Lee; Sang-Cheol Bae

doi:10.4078/jrd.22.0006

Predictive Factors for Renal Response in Lupus Nephritis: A Single-center Prospective Cohort Study

J Rheum Dis. 2022 Oct 1;29(4):223-231. doi: 10.4078/jrd.22.0006. Epub 2022 Jul 5.

Authors

Dae Jin Park^{1

2}, Young Bin Joo^{1

2}, So-Young Bang^{1

2}, Jiyoung Lee², Hye-Soon Lee^{1

2}, Sang-Cheol Bae^{1

2}

Affiliations

¹ Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
² Hanyang University Institute for Rheumatology, Seoul, Korea.

Abstract

Objective: To identify the predictive factors for renal response in patients with lupus nephritis (LN).

Methods: Patients and data were extracted from a prospective systemic lupus erythematosus cohort in Korea, in which clinical data were collected at 0, 3, 6, and 12 months after induction therapy. Treatment response of LN were evaluated as a complete response (CR), partial response (PR), or non-response (NR) at 3, 6, and 12 months, respectively. Predictive factors for CR at 6 months were evaluated using multivariable Poisson regression analysis.

Results: A total of 75 patients with LN who underwent biopsy was enrolled. The mean age at diagnosis of LN was 28.9±9.7 years, and 68 (90.7%) were female. The frequencies of classes III, IV, III+V, IV+V, and V were 20.0%, 44.0%, 16.0%, 12.0%, and 8.0%, respectively. Compared to relapsed LN, new-onset LN showed a lower percentage of glomerulosclerosis (45.5% vs. 76.2%, p=0.013). The overall proportions of CR, PR, and NR at 6 and 12 months were 52.0%, 26.7%, 21.3% and 50.7%, 24.0%, 25.3%, respectively. In multivariate analysis, age at enrollment (odds ratio [OR]=1.02, p=0.022), relapsed LN (OR=0.71, p=0.037), anti-Ro antibody (OR=0.67, p=0.014), and class III LN (OR=1.48, p=0.001) were associated with CR at 6 months.

Conclusion: In our prospective cohort, class III LN was a good predictive factor for CR at 6 months in patients with LN, whereas younger age, relapsed LN, and anti-Ro antibody were poor predictive factors.

Keywords: Lupus nephritis; Outcome assessment; Risk factor; Systemic lupus erythematosus.

Grants and funding

FUNDING Dr. Sang-Cheol Bae (corresponding author) is supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (NRF-2021R1A6A1A03038899).