Methods: Three hundred and twenty cases of biopsy-proven DPLN with ≥10% crescents (cDPLN) were included in this study. Another
180 DPLN patients without crescents were enrolled as a control group. Their clinicopathological data and long-term outcome were compared. Results: There were 280 females and 40 males with an average age of 31.8 ± 11.3 years followed for a median period of 7 years. Compared with the control HM781-36B mw group, cDPLN patients had a significant lower rate of clinical remission (CR+PR) (90.3% vs 96.5%, p = 0.036) for longer period (10.1 ± 7.9 vs 8.9 ± 7.6 months, p = 0.154), much higher rate of treatment failure (9.7% vs 3.5%, p = 0.036) and relapse (41.5% vs 37.8%, p = 0.511). The 5-, 10-and 15-year cumulative renal survival rates of cDPLN and the control group were 87% vs 90.8%, 73.3% vs 81.6% and 58.7 vs 81.6%, respectively. At the time of biopsy, higher percentage of crescents (HR 1.030, P = 0. 001), fibro-cellular crescents (HR 1.025, P = 0. 002), glomerular sclerosis (HR 1.033, P = 0. 022), impaired renal function (HR 1.519, P < 0.001), decreased eGFR (HR3.567, P = 0.003), higher levels of NAG enzyme (HR 1.009, P = 0. 014), urinary C3 (HR 1.046, P = 0. 024), serositis history (HR 2.814, P = 0. 013), failure to achieve clinical remission (HR 0.144,
P < 0.001) and relapse (HR 11.634, P = 0. 020), were the independent risk factors for worse renal survival of cDPLN patients. Multivariate find more Cox analysis showed the percentage of glomerular sclerosis was the most important risk factor of ESRD. Conclusion: cDPLN had worse treatment response and lower probability of renal survival than those without crescents. Ten clinicopathological features including a higher percentage of crescents, fibro-cellular crescents, glomerular sclerosis, impaired renal function, higher NAG enzyme, urinary C3, history of serositis, failure of achieving clinical remission and relapse were independent predictors of an unfavorable renal outcome. IKEUCHI HIDEKAZU, HIROMURA KEIJU, TSHILELA
KADIOMBO A, KAYAKABE KEN, SAKURAI NORIYUKI, SAKAIRI TORU, KANEKO YORIAKI, MAESHIMA AKITO, NOJIMA YOSHIHISA Department of Medicine and Clinical Science, Gunma University much Graduate School of Medicine Introduction: In this study we sought to identify predictive factors for renal insufficiency in patients with lupus nephritis (LN). Methods: We retrospectively analyzed 155 biopsy proven LN patients (21 male, 134 female) at our department between 1976 and 2012. Renal histology was classified by ISN/RPS 2003 classification. A renal endpoint was defined as doubling of serum creatinine (S-Cr) or end-stage renal disease. Results: The mean age at renal biopsy was 36.5 ± 13.2 years.