Early remission may preserve long-term renal function in lupus nephritis

People with lupus nephritis (LN) who did not achieve renal remission were at a greater risk of chronic kidney disease (CKD) and end-stage renal disease, according to a study investigating the long-term consequences of the absence of remission in LN.

In this retrospective analysis, 128 patients with biopsy-proven class III, IV, or V incident LN were followed for a median of 134 months with a minimum of 25 months.

Renal remission, defined as a urine protein to creatinine ratio <0.5 g/g and a serum creatinine value <120% of baseline, was not achieved in 20% of patients. Baseline characteristics were not found to be different between patients who achieved remission and those who did not, but not achieving renal remission was associated with a 3-fold and 10-fold higher risk of chronic kidney disease and end-stage renal disease, respectively. When early remission was achieved, patients had significantly higher estimated glomerular filtration rate (eGFR) at last follow-up compared to patients who achieved remission later.

Reference
Pirson V, Enfrein A, Houssiau FA, et al. Absence of renal remission portends poor long-term kidney outcome in lupus nephritis. Lupus Sci Med. 2021;8(1):e000533. doi: 10.1136/lupus-2021-000533. PMID: 34446568.