PREDICTORS OF POOR RENAL EVOLUTION IN PATIENTS WITH LUPUS NEPHRITIS
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Abstract
Objectives: To determine the proportion and predictive factors of poor renal function progression after 6 months in lupus nephritis patients who underwent renal biopsy at Thong Nhat Hospital.
Subjectives and methods: A retrospective and prospective cohort study was conducted on 50 patients diagnosed with lupus nephritis who underwent renal biopsy at the Nephrology - Dialysis Department, Thong Nhat Hospital from January 2013 to July 2025. Inclusion criteria: (1) Diagnosed with lupus nephritis based on SLICC 2012 criteria, updated by KDIGO 2024; (2) Having renal biopsy results classified by the ISN/RPS system. Exclusion criteria: (1) Class VI lupus nephritis (global sclerosis); (2) Co-morbidities of other non-lupus glomerular diseases; (3) Insufficient clinical and subclinical data.
Results: The proportion of patients with poor renal function progression after 6 months was 82.0% (41/50 patients). Multivariate logistic regression analysis showed that proliferative histopathology was the only independent predictive factor with statistical significance (p = 0.037). The presence of proliferative lesions increased the risk of poor renal function progression by 21.537 times compared to other classes (OR = 21.537; 95% CI: 1.196 - 387.987).
Conclusions: The rate of poor renal function progression in severe lupus nephritis patients (indicated for biopsy) is exceptionally high. Proliferative histopathological lesion is a strong and independent predictor for this outcome.
Keywords
Lupus nephritis, poor renal progression, renal biopsy, proliferative histopathology
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References
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