RESPONSE TO TREATMENT AS A PREDICTOR OF LONG-TERM OUTCOME IN PATIENTSWITH LUPUS NEPHRITIS

Objective. To evaluate response to therapy over one year as a predicto r of several longterm outcomes in lupus nephritis. Methods. Response t o treatment was evaluated by comparing serum creatinine and 24 h urine protein excretion at initial renal biopsy to those obtained after one year of treatment. Response at one year was evaluated as a predictor of renal failure, death due to lupus nephritis, and total lupus mortal ity, using survival analysis. Results. Eighty-five patients with lupus nephritis diagnosed between 1967 and 1983 and followed through 1990 w ere studied. Change in proteinuria was a powerful predictor of renal f ailure (p = 0.001) death due to lupus nephritis (p < 0.001) and overal l lupus mortality (p = 0.001). In contrast to a recent study of patien ts selected for severe lupus nephritis, serum creatinine was not found to be of prognostic significance. Conclusion. Response of proteinuria to treatment over one year is a useful predictor of longterm outcomes in lupus nephritis.