THU0249 CLINICAL FEATURES AND RENAL PROGNOSIS IN LUPUS NEPHRITIS PATIENTS UNDERGOING A REPEATED BIOPSY: RESULTS OF 103 RE-BIOPSIES IN 438 PATIENTS
| Autor: | Piergiorgio Messa, Renato Alberto Sinico, Francesca Saccon, Paolo Gilles Vercelloni, Federico Alberici, Giulia Frontini, Mariele Gatto, Valentina Binda, G. Moroni, Francesca Radice, Andrea Doria |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Creatinine Kidney medicine.diagnostic_test business.industry Immunology Lupus nephritis Renal function medicine.disease General Biochemistry Genetics and Molecular Biology Serology chemistry.chemical_compound medicine.anatomical_structure Blood pressure Rheumatology chemistry Internal medicine Biopsy medicine Immunology and Allergy Renal biopsy business |
| Zdroj: | Annals of the Rheumatic Diseases. 79:351.1-352 |
| ISSN: | 1468-2060 0003-4967 |
| DOI: | 10.1136/annrheumdis-2020-eular.3523 |
| Popis: | Background:Indications to repeat renal biopsy (RB) in lupus nephritis (LN) are not unanimously acknowledged.Objectives:To evaluate the renal outcome of patients with LN undergoing a second RB.Methods:We retrospectively analyzed prospectively collected data of patients with LN followed up in four Italian referral centres for systemic lupus eryhtematosus. Serological and clinical information were retrieved according to a shared database. RB were classified according to ISN/RPS 2003 classification; chronicity (CI) and activity indexes (AI) were defined according to Austin et al. The primary renal outcome was renal failure, defined as serum creatinine (SCr)>1.0mg/dL with eGFRResults:Four-hundred and thirty-eight patients were recruited. One-hundred and three patients repeated RB after 6.1±4.7 (mean± SD) years from the first due to: protocol biopsy due to renal remission (Group 1, n=8); proteinuric flare (Group 2, n=51); worsened renal function (Group 3, n=26); partial renal response (Group 4 n=18). Patients undergoing a second RB were younger (pConclusion:Patients undergoing a repeated RB had more aggressive clinical and histological features already at first RB and developed renal failure more frequently. Among baseline features, uncontrolled hypertension had the strongest association with renal failure, thus suggesting that control of blood pressure since early stages is highly advisable.References:[1]Austin HA, et al. Predicting renal outcomes in severe lupus nephritis: contributions of clinical and histologic data. Kidney Int 1994;45:544–50.Table .Comparison of patients undergoing 2nd RB according to development of renal failureRenal failure (n=26)No renal failure (n=69)*pTotal FU (years), mean (SD)21 (10.4)16.5 (9.39)0.002SCr (mg/dl) at 2° RB, mean (SD)1.7 (1)0.98 (0.35)0.001Proteinuria (g/24h) at 2° RB, mean (SD)4.7 (3.9)2.99 (2.63)0.022Class IV and IV+V at 2° RB, %76.954.50.07Hypertension at onset, %84.632.4HCQ intake at 2° RB, %9.552Glucocorticoids at 2° RB %8487nsImmunosuppressants at 2° RB %4058nsAI at onset, mean (SD)7.14 (3.95)7.02 (3.86)nsAI at 2° RB, mean (SD)5.37 (4.12)4.02 (3.71)nsCI at onset, mean (SD)2.05 (1.88)1.56 (1.64)nsCI at 2° RB, mean (SD)3.87 (3.08)3.52 (2.16)nsYears between 2° RB and end of FU, mean (SD)14.1 (10.5)9.3 (8.84)ns*Group 1 excludedRB, renal biopsy; AI, activity index; CI, chronicity index; SCr serum creatinine; FU, follow-up; SD, standard deviation.Disclosure of Interests:Mariele Gatto Speakers bureau: GSK, Francesca Saccon: None declared, Francesca Radice: None declared, Paolo Gilles Vercelloni: None declared, Renato Alberto Sinico: None declared, Giulia Frontini: None declared, Valentina Binda: None declared, Piergiorgio Messa: None declared, Federico Alberici: None declared, Gabriella Moroni: None declared, Andrea Doria Consultant of: GSK, Pfizer, Abbvie, Novartis, Ely Lilly, Speakers bureau: UCB pharma, GSK, Pfizer, Janssen, Abbvie, Novartis, Ely Lilly, BMS |
| Databáze: | OpenAIRE |
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