Clinical and prognostic value of serial renal biopsies in lupus nephritis

Moroni, Gabriella; Pasquali, Sonia; Quaglini, Silvana; Banfi, Giovanni; Casanova, S.; Maccario, Massimo; Zucchelli, P; Ponticelli, Claudio

doi:10.1016/s0272-6386(99)70082-x

Cited by 127 publications

(118 citation statements)

References 21 publications

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“…The committee defined improved as a 50% reduction in the urinary protein: urinary creatinine ratio. The literature is replete with definitions of improvement based on the 24-hour urine protein excretion level (5,9,15,16,18,24,32,34,35,38,47,52,66,72,74,75,80,81,(83)(84)(85)(86)(87)(88)(89)(90)(91)(92)(93)(94)(95)(96)(97)(98). In addition, the committee thought that a reduction in proteinuria from the nephrotic range (Ն3.5 gm/day) to the non-nephrotic range was an important and distinctive end point.…”

Section: Resultsmentioning

confidence: 99%

“…A partial response was defined as a urinary protein:urinary creatinine ratio of 0.2-2.0 (15,24,32,47,(90)(91)(92). A complete response was defined as a urinary protein:urinary creatinine ratio of Ͻ0.2 (15,24,32,35,47,52,(89)(90)(91)(92)(93). Worsened was defined as a doubling of the urinary protein:urinary creatinine ratio (i.e., increased by 100%).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

Liang

Schur

Fortin

et al. 2006

Arthritis & Rheumatism

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231

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

Liang

Schur

Fortin

et al. 2006

Arthritis & Rheumatism

Self Cite

231

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“…Most of the time this is due to LN flare, persistent proteinuria, or declining kidney function (66)(67)(68)(69)(70). Considering these investigations together, some generalizations about clinically-indicated repeat biopsies may be drawn.…”

Section: The Kidney Biopsy In Lnmentioning

confidence: 99%

Update on Lupus Nephritis

Almaani

Meara

Rovin

2016

CJASN

706

535

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SLE is a chronic inflammatory disease that affects the kidneys in about 50% of patients. Lupus nephritis is a major risk factor for overall morbidity and mortality in SLE, and despite potent anti-inflammatory and immunosuppressive therapies still ends in CKD or ESRD for too many patients. This review highlights recent updates in our understanding of disease epidemiology, genetics, pathogenesis, and treatment in an effort to establish a framework for lupus nephritis management that is patient-specific and oriented toward maintaining long-term kidney function in patients with lupus.

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“…Early clinical and histologic diagnosis of LN is pivotal in order to minimize the risk of progression to ESRD (79)(80)(81). In this setting, a renal biopsy is generally indicated in any case with acute increase in serum creatinine, proteinuria .500 mg/24 h or urine protein/creatinine ratio .0.5 g protein/g creatinine, hematuria in presence of any level of proteinuria, and active sediment/cellular casts (5).…”

Section: Whom To Biopsy and When To Biopsymentioning

confidence: 99%

“…A repeat renal biopsy should be considered in cases with persistent or worsening proteinuria, increasing serum creatinine during treatment, or development of an active sediment in patients with a previous nonproliferative lupus class. In this setting, repeat renal biopsy is particularly helpful in promptly instituting more vigorous treatment, when indicated (81). In patients with known class III or IV, a newly active sediment usually indicates a flare of proliferative LN, and a repeat biopsy may not be needed (44).…”

Section: Whom To Biopsy and When To Biopsymentioning

confidence: 99%

Lupus Nephritis

Giannico

Fogo

2013

Clinical Journal of the American Society of Nephrology

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SummaryMost patients with SLE develop kidney disease related to this systemic underlying disease process. Lupus nephritis is an important cause of morbidity and even mortality in patients with systemic lupus erythematosus. Lupus nephritis has diverse morphologic manifestations with varying clinical presentations and consequences. The pathogeneses involve immune complexes, which can deposit anywhere in the kidney, and other mechanisms, including endothelial injury, podocytopathy, and tubulointerstitial injury. Treatment and prognosis accordingly range from excellent even with only observation with minimal mesangial deposits, to kidney failure despite aggressive immunosuppression in patients with severe proliferative disease. Renal biopsy plays a crucial role in the diagnosis of the specific form of lupus nephritis in any patient. However, the role of the renal biopsy in prediction of outcome, treatment, and prognosis has been controversial. We will review the current classification of lupus nephritis and the value of renal biopsy in the management of these patients.

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Clinical and prognostic value of serial renal biopsies in lupus nephritis

Cited by 127 publications

References 21 publications

The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

Update on Lupus Nephritis

Lupus Nephritis

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