Prognostic value of renal biopsy and clinical variables in patients with lupus nephritis and normal serum creatinine

Objective - To evaluate Factors with possible influence on the renal outcom e in patients with lupus nephritis but without chronic renal insufficiency (CRT). Methods - Renal biopsies from 94 patients were re-assessed with regard to W HO class, activity, chronicity and tubulointerstitial indices without knowl edge of clinical features. The outcome parameters were CRI defined as irrev ersibly increased serum creatinine and renal end stage disease. Results - The risk ratios (RR) of developing CRI were 2.6 For active urinar y sediment, 3.1 for hyaline thrombi and 7.3 for glomerular leukocyte exudat ion. The RR of renal end stage disease was 5.0 when the duration of renal d isease exceeded one year at the time of biopsy and 4.3 when biopsy disclose d a class TV lesion. Glomerular sclerosis was also associated to renal end stage disease. Conclusion - Early renal biopsy and the above mentioned signs of active ren al disease carry prognostic information that may have significant therapeut ic implications.