CLINICOPATHOLOGICAL CORRELATIONS AND PROGNOSTIC FACTORS IN LUPUS NEPHRITIS

Objective. To define prognostic factors at the moment of the diagnosis in lupus nephritis, and to assess the contribution of renal histologi c data. Patients and methods. Sixty-two patients with systemic lupus e rythematosus (SLE) and histologic evidence of nephritis were studied f or renal outcome. Correlations between clinical or biological nod hist ological data were carried out as an indicator of the utility of the r enal biopsy. Results. There were no significant differences in creatin ine between the different histologic classes at the moment of the diag nosis, although the WHO classification correlated well with proteinuri a and immunologic activity There was a strong correlation between clin ical and histologic activity as measured by the activity index in prol iferative glomerulonephritis, mainly with creatinine and proteinuria, but not with haematuria or immunological activity. Young age at the ti me of renal biopsy, proliferative classes III and IV, and the chronici ty index were associated with a poorer renal prognosis. Conclusions. H igh immunologic activity, mainly elevated anti-DNA titers and decrease d levels of CH100, is highly suggestive of proliferative glomeruloneph ritis. Proliferative classes III and IV and high chronicity indexes ar e associated with a worse prognosis in lupus nephritis.