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BioMed Research International
Volume 2017 (2017), Article ID 5312960, 8 pages
https://doi.org/10.1155/2017/5312960
Research Article

Predictors of Good Long-Term Renal Outcomes in Lupus Nephritis: Results from a Single Lupus Cohort

Toronto Western Hospital, Centre for Prognosis Studies in the Rheumatic Diseases, University of Toronto Lupus Clinic, Toronto, ON, Canada

Correspondence should be addressed to Zahi Touma

Received 30 April 2017; Accepted 3 July 2017; Published 21 August 2017

Academic Editor: Nobuo Kanazawa

Copyright © 2017 William A. Fung et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This study aims to elucidate the predictive capabilities of proteinuria, serum creatinine (Cr), and urine RBCs (uRBCs) with respect to long-term renal outcomes in lupus nephritis (LN) in patients followed in clinic. Methods. A retrospective analysis was performed on patients with LN. We evaluated the ability of proteinuria, serum Cr, and uRBCs at 12 months to predict good long-term renal outcomes defined as serum Cr ≤ 100 mmol/L and kidney transplant/dialysis-free at the 7th year. Receiver operator characteristic curves were generated for proteinuria, serum Cr, and uRBCs to study their ability to predict good long-term outcomes and to identify their best cut-off. Descriptive statistics studied the pattern of change of proteinuria and serum Cr. Results. Proteinuria of 0.6 g/d and Cr of 83 mmol/L performed independently moderately well in predicting good long-term renal outcomes while uRBC was less accurate. Combining serum Cr to proteinuria gave a small increase in positive predictive value with a trade-off in sensitivity. Proteinuria changed within the first year whereas serum Cr changed until the 7th year. Conclusions. Both proteinuria and Cr predict good long-term renal outcomes in LN. Proteinuria’s ability to change faster at 12 months makes it a favorable endpoint for clinical trials and research studies.