Lupus & antiphospholipid syndrome
Remission of lupus nephritis: the trajectory of histological response in successfully treated patients
Authors' conclusion
Despite responding, LN kidneys accrue chronic damage early during treatment.
Study context
- Population
- Patients with proliferative±membranous lupus nephritis (LN) undergoing immunosuppressive treatment, with diagnostic biopsy (Bx1), Bx2 at 9 (6–15) months and Bx3 at 42 (28–67) months
- Exposure
- Histological remission vs persistent histological activity
- Outcome
- Change in kidney histological activity and chronicity indices (AI, CI) over time
Main finding
As reported in the abstract
Decline in AI
Fold greater early decline in AI (Bx1 to Bx2)
1.6
95% CI 1.30–1.91P = 0.01
Group 1
Fold greater AI decline (Bx2 to Bx3)
2.19
95% CI 2.09–2.29P = 7.34×10-5
Group 1
Observational data: associations, not effects.
Further findings
Resolution of individual AI components
- Glomerular crescents, karyorrhexis and necrosis mostly resolved by Bx2; endocapillary hypercellularity, subendothelial hyaline deposits and interstitial inflammation resolved slowly, accounting for residual activity at Bx3 in group 2
Increase in CI between Bx1 and Bx2, then plateau
- CI increase per month between Bx1 and Bx2
- 0.15 units/month
- No differences in rate of chronic damage accumulation between group 1 and group 2
CI increase related to severity of lesions at Bx1
- Glomerular crescents
- P = 0.044
- Subendothelial hyaline deposits
- P = 0.002
- Interstitial inflammation
- P = 0.015
Original publication
Remission of lupus nephritis: the trajectory of histological response in successfully treated patients. Lupus Sci Med. Published 31 May 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →