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Renal response and its predictive factors of lupus nephritis: a 2-year real-world study of 56 hospital-based patients

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Abstract

Objectives

Our aim was to evaluate the renal response rate of patients with lupus nephritis (LN) undergoing standard treatment during a 2-year follow-up and to investigate its predictive factors.

Methods

A prospective cohort study that enrolled 56 clinically diagnosed LN patients with urinary protein positivity was carried out. All patients underwent standard treatment. All patients were followed up at 6-month intervals for 2 years. Data on renal response and clinical characteristics were collected and analyzed.

Results

Among 56 patients, 27 (48.2%) and 13 (23.2%) patients achieved complete renal response (CR) and partial renal response (PR) at 6 months after induction therapy, respectively, and 42 (75.0%) and 4 (7.1%) patients developed CR and PR at 2 years. Among patients who achieved PR at 6 months, 90.0% achieved CR at 24 months, while only 37.5% of the patients who were unresponsive at 6 months achieved CR. In the multivariable Cox proportional-hazards model, female (OR 6.51, 95% CI 1.23–34.52, p = 0.028), disease duration (OR 0.84, 95% CI 0.73–0.98, p = 0.021), achieving PR within 6 months (OR 8.09, 95% CI 2.06–31.73, p = 0.003), and urine protein/creatinine ratio (UPCR) (OR 0.998, 95% CI 0.996–1.000, p = 0.025) were found to be predictive factors of CR.

Conclusion

A total of 48.2% of patients achieved CR at 6 months of induction therapy, and the response rates gradually increased to 60.7%, 64.3%, and 75.0% at 12, 18, and 24 months. Besides, female, disease duration, partial response within 6 months, and UPCR were predictive factors for a complete renal response.

Key Points

• We evaluate the renal response rates in Chinese patients with lupus nephritis in the real world for 2 years.

• A total of 48.2% and 75.0% of patients achieved a complete response after standard treatment for 6 months and 2 years.

• Female, disease duration, partial response within 6 months, and UPCR are predictors of complete renal response.

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Data availability

The data underlying this manuscript will be shared upon reasonable request to the corresponding author.

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Funding

Zhimin Lin acknowledges the financial support from Ten & Five Project of the Third Affiliated Hospital of Sun Yat-Sen University (Grant No. SW201901) and Distinguished Young Scholar Candidates Program for The Third Affiliated Hospital of Sun Yat-Sen University (Grant No. A2675).

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Author notes

  1. Keqian Du and Xuecheng Zhang contributed equally.

Authors and Affiliations

  1. Department of Rheumatology, Third Affiliated Hospital of Sun Yat-Sen University, No. 600, Rd. Tianhe, Tianhe District, Guangzhou City, Guangdong Province, 510630, People’s Republic of China

    Keqian Du, Sijie Zhong, Jun Qi & Zhiming Lin

  2. Department of Nephrology, BaoAn Central Hospital of Shenzhen, Shenzhen, 518100, People’s Republic of China

    Xuecheng Zhang

  3. Division of Rheumatology, NanFang Hospital of Southern Medical University, Guangzhou, 510080, People’s Republic of China

    Junmei Feng

Authors
  1. Keqian Du
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  2. Xuecheng Zhang
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  4. Sijie Zhong
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  5. Jun Qi
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Contributions

All authors contributed to the study conception and design. Zhiming Lin and Jun Qi conceived the idea. Material preparation, data collection, and analysis were performed by Keqian Du, Junmei Feng, and Xuecheng Zhang. The first draft of the manuscript was written by Keqian Du. Sijie Zhong offered significant suggestions for revisions. All the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding authors

Correspondence to Jun Qi or Zhiming Lin.

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Ethics approval

The study was approved by the Medical Ethics Committee of the Third Affiliated Hospital of Sun Yat-Sen University (NO.:02–355-01).

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Written informed consents were signed by all participants.

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Du, K., Zhang, X., Feng, J. et al. Renal response and its predictive factors of lupus nephritis: a 2-year real-world study of 56 hospital-based patients. Clin Rheumatol 41, 3363–3371 (2022). https://doi.org/10.1007/s10067-022-06258-0

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