EVALUATION OF CLINICAL AND PATHOLOGICAL FINDINGS AND TREATMENT OUTCOMES OF PATIENTS WITH LUPUS NEPHRITIS A SINGLE CENTRE EXPERIENCE

Objective: Renal involvement in systemic lupus erythematosus (SLE), also known as lupus nephritis (LN), leads to a worse prognosis than SLE without kidney involvement. Material and Methods: Biopsy-proven LN patients diagnosed between January 2012 and January 2021 were reviewed. Complete remission (CR) was defined as a reduction in the urinary protein-to-creatinine ratio (UPCR) below 0.50 g/g. Partial response is characterised by a 24-h urine protein excretion reduction to below 3 g/day with at least a 50% decrease in proteinuria. Primary effective renal response was defined as PCR of less than 0.7 g/g and the absence of any rescue therapy for treatment failure. Result: All patients exhibited proteinuria at diagnosis, with class IV LN being the most common (36.4%) form, and 65.9% had proliferative LN. At 12 months, CR was achieved in 16 patients (37.2%) with significant differences in systolic and diastolic blood pressure and eGFR at diagnosis (p=0.01, p=0.02, and p=0.016, respectively). CR rates were lower at 12 months in patients with proliferative LN (p=0.024) and interstitial inflammation (p=0.04). Besides, no significant difference was found in CR rates at 6 and 12 months between PLN patients treated initially with steroids and cyclophosphamide and those treated with steroids and mycophenolate mofetil (p>0.05). However, the median time to achieve CR was shorter in the mycophenolate mofetil group (p=0.048). Conclusion: LN remains a significant source of morbidity and mortality in patients with SLE; therefore, early diagnosis and prompt initiation of the treatment are crucial for renal and patient survival.