Progressive improvement of patient and renal survival and reduction of morbidity over time in patients with lupus nephritis (LN) followed for 20 years

G. Moroni, S. Quaglini, B. Gallelli, G. Banfi, P. Messa, C. Ponticelli

Research output: Contribution to journalArticlepeer-review

Abstract

Whether the long-term patient and renal survival of those diagnosed with lupus nephritis (LN) has improved over the decades is still debated. Eighty-nine patients diagnosed between 1968 and 1990 entered this study and their outcome was evaluated after 20 years. At presentation 54% of patients had class IV LN, 39.3% had renal insufficiency and 59.5% had nephrotic syndrome. Patients were divided into two groups: Group 1 consisted of 30 patients diagnosed between 1968 and 1980; Group 2 consisted of 59 patients diagnosed between 1981 and 1990. In Group 1 patient survival at 20 years was 84% versus 95% in Group 2 (p = 0.05). Survivals without end-stage renal failure were respectively 75% and 84% at 20 years (p = 0.05). Survivals without severe infection at 20 years were 44% in Group 1 and 66.5% in Group 2 (p = 0.02). Survivals without cardiovascular events at 20 years were: 53% in Group 1 and 90% in Group 2 (p = 0.005). At presentation, patients in Group 1 had higher serum creatinine (1.96 vs 1.15 mg/dl, p = 0.01), higher activity index (8 vs 5.5, p = 0.01), lower hematocrit (31% v s6%, p = 0.008) and lower serum C4 levels (p = 0.04) than Group 2 patients. Patients in Group 1 also received less frequent methylprednisolone pulses (43% v s81%, p = 0.0006). In Italian patients with LN, long-term life expectancy and renal survival progressively improved over the decades, while morbidity progressively declined. An earlier referral and refinement of therapy achieved this goal.

Original languageEnglish
Pages (from-to)810-818
Number of pages9
JournalLupus
Volume22
Issue number8
DOIs
Publication statusPublished - Jul 2013

Keywords

  • immunosuppressive therapy
  • lupus nephritis
  • Lupus patient survival
  • lupus renal survival
  • methylprednisolone pulses
  • systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology

Fingerprint Dive into the research topics of 'Progressive improvement of patient and renal survival and reduction of morbidity over time in patients with lupus nephritis (LN) followed for 20 years'. Together they form a unique fingerprint.

Cite this