scholarly journals THU0274 RENAL CHARACTERISTICS AND OUTCOME OF LUPUS NEPHRITIS ACCORDING TO ITS TIME OF ONSET

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 364.1-364
Author(s):  
O. C. Kwon ◽  
J. H. Park ◽  
M. C. Park
Keyword(s):  
Lupus Nephritis ◽  
Early Onset ◽  
Cox Regression ◽  
Onset Time ◽  
Renal Outcome ◽  
Cox Regression Analysis ◽  
Initial Onset ◽  
Renal Relapse ◽  
Stage Renal Disease ◽  
End Stage

Background:Lupus nephritis (LN) usually develops within 5 years of systemic lupus erythematosus (SLE) onset. It is unclear whether the course and outcome of LN differ between patients who initially had LN at SLE onset (initial-onset LN) and those who developed LN within 5 years after SLE onset (early-onset LN).Objectives:To compare clinical characteristics and renal outcomes between SLE patients with initial-onset LN and SLE patients with early-onset LN.Methods:SLE patients with biopsy-proven LN were retrospectively reviewed. The clinical parameters and renal outcomes were compared between initial-onset LN and early-onset LN groups. We used Cox regression analysis to estimate risk of worse renal outcome, according to the onset time of LN.Results:Of the total 136 LN patients, 92 (67.6%) and 44 (32.4%) patients were classified into the initial-onset and early-onset LN groups, respectively. The initial-onset LN group had higher prevalences of impaired renal function (34.8% vs. 11.4%, p=0.004) and microscopic hematuria (73.9% vs. 54.5%, p=0.024), and higher urine protein/creatinine ratio (4626.1 [2180.0–6788.3] vs. 2410.0 [1265.0–5168.5] mg/g, p=0.006) at LN diagnosis. Renal relapse (46.3% vs 25.7%, p=0.039) and progression to chronic kidney disease (CKD) or end-stage renal disease (ESRD) were more common (24.4% vs. 8.3%, p=0.042) in the initial-onset LN group. In the multivariable Cox regression analysis, initial-onset LN group had higher risk of renal relapse (adjusted hazard ratio [HR] 2.938, 95% confidence interval [95% CI] 1.344–6.426, p=0.007) and progression to CKD or ESRD (adjusted HR 4.642, 95% CI 1.107–19.458, p=0.036), compared with early-onset LN group.Conclusion:Patients with LN at SLE onset may have more severe renal presentations and worse renal outcome than those who develop LN within 5 years.References:Not applicableTable.Hazard ratios for renal relapse and progression to CKD/ESRD according to onset time of LNUnivariable analysisMultivariable analysisaHR (95% CI)pHR (95% CI)pRenal relapseEarly-onset LN1.000 (reference)1.000 (reference)Initial-onset LN2.734 (1.315–5.686)0.0072.938 (1.344–6.426)0.007Progression to CKD/ESRDEarly-onset LN1.000 (reference)1.000 (reference)Initial-onset LN4.201 (1.249–14.132)0.0204.642 (1.107–19.458)0.036aAdjusted for age, ISN/RPS class, activity index, chronicity index, GFR, UPCR, hematuria and use of HCQLN, lupus nephritis; CKD, chronic kidney disease; ESRD, end-stage renal disease; ISN/RPS, International Society of Nephrology/Renal Pathology Society (ISN/RPS); GFR, glomerular filtration rate; UPCR, urine protein/creatinine ratio; HCQ, hydroxychloroquine; HR, hazard ratio; CI, confidence intervalAcknowledgments:None.Disclosure of Interests:None declared

scholarly journals Real-world evidence and optimization of vocal dysfunction in end-stage renal disease patients with secondary hyperparathyroidism

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Geng-He Chang ◽  
Fong-Fu Chou ◽  
Ming-Shao Tsai ◽  
Yao-Te Tsai ◽  
Ming-Yu Yang ◽  
...  
Keyword(s):  
Renal Disease ◽  
Secondary Hyperparathyroidism ◽  
Real World ◽  
End Stage Renal Disease ◽  
Cox Regression ◽  
Electrolyte Imbalance ◽  
Research Database ◽  
Cox Regression Analysis ◽  
Stage Renal Disease ◽  
End Stage

AbstractPatients with end-stage renal disease (ESRD) may demonstrate secondary hyperparathyroidism (SHPT), characterized by parathyroid hormone oversecretion in response to electrolyte imbalance (e.g., hypocalcemia and hyperphosphatemia). Moreover, this electrolyte imbalance may affect vocal cord muscle contraction and lead to voice change. Here, we explored the effects of SHPT on the voices of patients with ESRD. We used data of 147,026 patients with ESRD from the registry for catastrophic illness patients, a sub-database of Taiwan National Health Insurance Research Database. We divided these patients into 2 groups based on whether they had hyperparathyroidism (HPT) and compared vocal dysfunction (VD) incidence among them. We also prospectively included 60 ESRD patients with SHPT; 45 of them underwent parathyroidectomy. Preoperatively and postoperatively, voice analysis was used to investigate changes in vocal parameters. In the real-world database analysis, the presence of HPT significantly increased VD incidence in patients with ESRD (p = 0.003): Cox regression analysis results indicated that patients with ESRD had an approximately 1.6-fold increased VD risk (p = 0.003). In the clinical analysis, the “jitter” and “shimmer” factors improved significantly after operation, whereas the aerodynamic factors remained unchanged. In conclusion, SHPT was an independent risk factor for VD in patients with ESRD, mainly affecting their acoustic factors.

MO757COMPARISON OF ANTI-COAGULATION AND NO ANTI-COAGULATION IN DIALYSIS PATIENTS WITH ATRIAL FIBRILLATION: A SINGLE CENTER RETROSPECTIVE STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Jun Young Lee ◽  
Jae Won Yang ◽  
Jae Seok Kim ◽  
Seong Ok Choi ◽  
Byoung Geun Han
Keyword(s):  
Atrial Fibrillation ◽  
Cox Regression ◽  
Dialysis Patients ◽  
Dialysis Therapy ◽  
Cox Regression Analysis ◽  
Significant Difference ◽  
Baseline Characteristics ◽  
Stage Renal Disease ◽  
End Stage ◽  
Risk And Benefit

Abstract Background and Aims Atrial fibrillation (AF) is common arrhythmia in end stage renal disease patients. Although, the need of anticoagulation to prevent stroke and thromboembolism is increasing, the efficacy of anticoagulation is not proven in most of study. We retrospectively analyzed the risk and benefit of anticoagulation in dialysis patients with AF. Method By using medical record, we retrospectively analyzed all data of 99 patients who received dialysis therapy and diagnosed AF. Results Among 99 patients who diagnosed AF with dialysis 36 patients received anticoagulation (17 coumadin, 19 apixaban 2.5mg bid), 63 patients received no anticoagulation. There was no significant difference of baseline characteristics between anticoagulation, and no anticoagulation patients. Although no anticoagulation group experienced more all-cause (39.7% vs 32.4%, p=0.572) and cardiovascular mortality (17.6% vs 10.8%, p=0.197) than anticoagulation group it was not statistically significant. Compared to apixaban 2.5mg bid patients, coumadin anticoagulation patients experienced more frequent mfig ajor adverse cardiovascular events (35.3% vs 15.8%, p=0.109) but it was not statistically significant in multi variate Cox regression analysis (Hazard ratio 1.143, 95% Confidence Interval 0.503-2.597). Conclusion Apixaban 2.5mg bid was not inferior than coumadin considering risk and benefit of anticoagulation in dialysis patients.

scholarly journals Proteinuria and serum creatinine after 12 months of treatment for lupus nephritis as predictors of long-term renal outcome: a case–control study

2022 ◽  
Vol 62 (1) ◽  
Author(s):  
Fernanda Nogueira Holanda Ferreira Braga ◽  
Marta Maria das Chagas Medeiros ◽  
Antonio Brazil Viana Junior ◽  
Matheus Eugênio de Sousa Lima ◽  
Levi Coelho Maia Barros ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Renal Disease ◽  
Serum Creatinine ◽  
Roc Curve ◽  
End Stage Renal Disease ◽  
Renal Outcome ◽  
Renal Outcomes ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Lupus nephritis (LN) is a major source of morbidity and mortality in patients with systemic lupus erythematosus (SLE), with 10–25% of patients progressing to end-stage renal disease (ESRD). Objective This study aims to elucidate the predictive capabilities of 24-h proteinuria (24PTU) and serum creatinine (sCr) after 12 months of treatment with respect to long-term renal outcomes in LN in a single-center cohort of LN patients. Methods A retrospective analysis was performed on 214 patients diagnosed with LN followed in our center. Values of 24PTU and sCr were assessed at baseline and after 3, 6 and 12 months, and after 5 years and/or the last evaluation. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 for 3 months or longer. End-stage renal disease (ESRD) was defined as the need for permanent dialysis. Receiver operating characteristics curves (ROC) were used to test the best cut-off value of 24PTU and sCr at 12 months who predict bad long-term renal outcomes.  Results The mean follow-up period was 11.2 ± 7.2 years. The best cut-off values for 24PTU and sCr as predictor of CKD were, respectively, 0.9 g/24 h and 0.9 mg/dL. ROC curve for 24PTU had a slightly lower performance than ROC curve for sCr as predictor for CKD (PTU AUC = 0.68; sCr AUC = 0.70), but sensitivity and specificity were better for 24PTU (24PTU: sensitivity = 63.5%, specificity = 71.2%; sCr: sensitivity = 54.8%, specificity = 75.3%). When the outcome was ESRD the best cut-off points were 0.9 g/24hs and 1.3 mg/dL for 24PTU and sCr, respectively, and the curve performance was better for 24PTU (PTU AUC = 0.72; sCr AUC = 0.61). Conclusions In this ethnically diverse population with LN followed for a long time (> 10 years), levels of 24PTU > 0.9/day at 12 months was a good predictor of bad long-term renal outcome. The serum creatinine > 0.9 mg/dL and > 1.3 mg/dL at 12 months were also good predictors of CKD and ESRD, respectively. Patients with 24PTU < 0.9 g/day and sCr < 1.3 mg/dL at 12 months are not likely to develop ESRD because of the high negative predictive values (NPV) (93.2% and 82%). 24PTU and sCr are relevant as components for a treat-to-target strategy for LN treatment, since their high NPV corroborates their importance as good predictors of long-term renal outcome.

Increased urinary miR-196a level predicts the progression of renal injury in patients with diabetic nephropathy

2018 ◽  
Vol 35 (6) ◽  
pp. 1009-1016 ◽  
Author(s):  
Yu An ◽  
Changming Zhang ◽  
Feng Xu ◽  
Wei Li ◽  
Caihong Zeng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Renal Injury ◽  
Cox Regression ◽  
Interstitial Fibrosis ◽  
Glomerular Sclerosis ◽  
Tubular Atrophy ◽  
Cox Regression Analysis ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Recent data suggest that miR-196a is predominantly expressed in the kidney and plays an inhibitory role in the progress of renal interstitial fibrosis (IF). However, the predictive value of miR-196a in diabetic nephropathy (DN) remains unknown. We validated the role of urinary miR-196a in the progression of renal injury in a cohort of patients with type 2 diabetes mellitus. Methods Our study included 209 patients with biopsy-proven DN. The mean follow-up time was 54.03 ± 32.94 months. Histological lesions were assessed using the pathological classification established by the Renal Pathology Society. Percentages of IF and tubular atrophy were assessed using the Aperio ScanScope system. We measured the correlation of urinary miR-196a with clinical and pathological parameters using the Spearman’s correlation test. The influence of urinary miR-196a on renal outcomes was assessed using Cox regression analysis. Results Urinary miR-196a levels correlated positively with proteinuria (ρ = 0.385, P &lt; 0.001), duration of diabetes mellitus (ρ = 0.255, P &lt; 0.001) and systolic blood pressure (ρ = 0.267, P &lt; 0.001). The baseline estimated glomerular filtration rate (eGFR) and hemoglobin level showed a negative correlation with urinary miR-196a (ρ = −0.247, P &lt; 0.001 and ρ = −0.236, P = 0.001, respectively). Pathologically, urinary miR-196a levels correlated with glomerular sclerosis and IF in patients with DN. Urinary miR-196a was significantly associated with progression to end-stage renal disease [hazard ratio (HR) 2.03, P &lt; 0.001] and a 40% reduction of baseline eGFR (HR 1.75, P = 0.001), independent of age, gender, body mass index, mean arterial pressure and hemoglobinA1c level. However, urinary miR-196a did not improve predictive power to proteinuria and eGFR in DN patients. Conclusions Increased urinary miR-196a was significantly associated with the progression of renal injury and might be a noninvasive prognostic marker of renal fibrosis in DN patients.

Histological predictors of renal outcome in lupus nephritis: the importance of tubulointerstitial lesions and scoring of glomerular lesions

Lupus ◽  
2018 ◽  
Vol 27 (9) ◽  
pp. 1455-1463 ◽  
Author(s):  
B Obrișcă ◽  
R Jurubiță ◽  
A Andronesi ◽  
B Sorohan ◽  
C Achim ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Kidney Biopsy ◽  
Renal Outcome ◽  
Predictors Of Outcome ◽  
End Point ◽  
Tubulointerstitial Lesions ◽  
Cox Proportional Hazard Regression ◽  
Stage Renal Disease ◽  
End Stage

Introduction Lupus nephritis (LN) affects nearly 60% of patients with systemic lupus erythematosus and up to 30% of them will progress to end-stage renal disease (ESRD), despite receiving aggressive immunosuppressive therapy. The prognostic value of ISN/RPS classification is controversial. Therefore, we aimed to identify clinical and pathological predictors of outcome in LN patients independent of this classification. Material and methods Thirty-seven patients with LN who underwent percutaneous kidney biopsy between 1997 and 2016 were included in this study. Twenty clinical and twenty histological variables were tested for their association with a composite end-point of doubling of serum creatinine, ESRD and death. Univariate and multivariate Cox proportional hazard regression analysis were performed to identify independent predictors of outcome. Results During a median follow-up period of 48 months (IQR: 17.5–120 months), 21.6% of patients reached the composite end-point. The overall survival rate of our cohort was 89% at one year, 86% at five years, 74% at 10 years and 64% at 20 years. Patients with Class IV LN showed the worst prognosis with 44% survival at 10 years, while those who additionally showed crescents and global sclerosis on kidney biopsy had an even lower survival of 21% and 0% at 10 years, respectively. After multivariate adjustment, we identified estimated glomerular filtration rate at baseline (HR, 0.91 per ml/min /1.73 m2; 95% CI, 0.84 to 0.99), 24-hour proteinuria at baseline (HR, 2.04 per g/d; 95% CI, 1.19 to 3.5), crescents (HR, 1.068 per %; 95% CI, 1.003 to 1.091), global sclerosis (HR, 1.036 per %; 95% CI, 0.984 to 1.091), presence of adhesions (HR, 9.2; 95% CI, 1.38 to 61.2) and tubulitis (HR, 13.1; 95% CI; 1.3 to 131) as independent predictors of outcome in our cohort of LN. Conclusions Our study identified glomerular (crescents, global sclerosis, adhesions) and tubulointerstitial (tubulitis) lesions, in addition to clinical variables (renal function, 24-hour proteinuria), as important predictors of renal outcome, independent of the ISN/RPS classification. We suggest that the ISN/RPS classification could be improved by a quantitative assessment of glomeruli with active and chronic lesions and by a greater emphasis given to tubulointerstitial lesions.

scholarly journals Evaluation of Electrocardiographic Parameters Predicting Cardiovascular Events in Patients with End-Stage Renal Disease before and after Transplantation

2019 ◽  
Vol 44 (4) ◽  
pp. 615-627 ◽  
Author(s):  
Laura Buerschaper ◽  
Jürgen Floege ◽  
Anja Mühlfeld ◽  
Georg Schlieper
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cox Regression ◽  
Early Stage ◽  
Predictive Marker ◽  
Cox Regression Analysis ◽  
Before And After ◽  
Stage Renal Disease ◽  
End Stage ◽  
Electrocardiographic Parameters

Background and Objectives: Cardiovascular (CV) mortality represents the leading cause of death in patients with end-stage renal disease (ESRD). Efficient screening is required to detect CV disease at an early stage, but the best diagnostic work-up is uncertain. The aim of this study was to identify electrocardiographic parameters in dialysis patients associated with an increased frequency of CV events. Methods: A 12-lead electrocardiogram was performed in 139 patients who were on the renal transplant waiting list and who subsequently received a kidney transplant. CV events were analyzed from the day of listing for kidney transplantation until 1 year after renal transplantation. Results: Multivariate Cox regression analysis showed that an elevated T:R ratio in anterior and inferior leads was independently associated with CV events (T:R ratio of anterior leads hazard ratio [HR] 1.32 [95% CI 1.09–1.59; p = 0.004] and inferior leads HR 2.15 [95% CI 1.23–3.77; p = 0.008]). In particular, a T:R ratio in inferior leads exceeding 0.6 was associated with CV events in a Kaplan-Meier analysis. Conclusions: Taken together, we found an increased T:R ratio in ESRD patients to be a predictive marker for CV events.

scholarly journals High Risk of Peritonsillar Abscess in End-Stage Renal Disease Patients: A Nationwide Real-World Cohort Study

2021 ◽  
Vol 18 (13) ◽  
pp. 6775
Author(s):  
Geng-He Chang ◽  
Ang Lu ◽  
Yao-Hsu Yang ◽  
Chia-Yen Liu ◽  
Pey-Jium Chang ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cox Regression ◽  
Peritonsillar Abscess ◽  
Deep Neck Infection ◽  
Research Database ◽  
Cox Regression Analysis ◽  
Neck Infection ◽  
Stage Renal Disease ◽  
End Stage

Background: Peritonsillar abscess (PTA) is an infectious emergency in the head and neck, and patients with end-stage renal disease (ESRD) have an immunocompromised status. However, no relevant research has focused on the ESRD–PTA relationship. This study explored PTA in ESRD patients and their prognosis. Methods: We identified 157,026 patients diagnosed as having ESRD over January 1997 to December 2013 from Taiwan’s National Health Insurance Research Database (NHIRD). Each patient with ESRD (hereafter, patients) was matched with one control without chronic kidney disease (CKD; hereafter, controls) by sex, age, urbanization level, and income. Next, PTA incidence until death or the end of 2013 was compared between the two groups, and the relative risk of PTA was analyzed using a multiple logistic regression model. Results: The patients had a significantly higher PTA incidence than did the controls (incidence rate ratio: 2.02, 95% confidence interval [CI]: 1.40–2.91, p < 0.001). The Kaplan–Meier analysis revealed that the patients had a higher cumulative incidence of PTA than did the controls (p < 0.001). In Cox regression analysis, the patients had nearly twofold higher PTA risk (adjusted hazard ratio [HR]: 1.98, 95% CI: 1.37–2.86, p < 0.001). The between-group differences in the PTA-related hospital stay length (8.1 ± 10.3 days in patients and 5.7 ± 4.6 days in controls, p = 0.09), consequent deep-neck infection complication (4.2% in patients and 6.3% in controls, p = 0.682), and mortality (0.0% in both groups) were nonsignificant. Conclusions: Although ESRD does not predict a poor prognosis of PTA, it is an independent PTA risk factor.

scholarly journals Absence of renal remission portends poor long-term kidney outcome in lupus nephritis

2021 ◽  
Vol 8 (1) ◽  
pp. e000533
Author(s):  
Valérie Pirson ◽  
Antoine Enfrein ◽  
Frédéric A Houssiau ◽  
Farah Tamirou
Keyword(s):  
Lupus Nephritis ◽  
Negative Impact ◽  
Renal Outcome ◽  
Class Iii ◽  
Treatment Change ◽  
Lower Egfr ◽  
Stage Renal Disease ◽  
End Stage

BackgroundThe very long-term consequences of absence of remission in lupus nephritis (LN) remain understudied.MethodsIn this retrospective analysis, we studied a selected cohort of 128 patients with biopsy-proven class III, IV or V incident LN followed for a median period of 134 months (minimum 25). Remission was defined as a urine protein to creatinine (uP:C) ratio <0.5 g/g and a serum creatinine value <120% of baseline. Renal relapse was defined as the reappearance of a uP:C >1 g/g, leading to a repeat kidney biopsy and treatment change. Poor long-term renal outcome was defined as the presence of chronic kidney disease (CKD).ResultsTwenty per cent of patients never achieved renal remission. Their baseline characteristics did not differ from those who did. Absence of renal remission was associated with a threefold higher risk of CKD (48% vs 16%) and a 10-fold higher risk of end-stage renal disease (20% vs 2%). Patients achieving early remission had significantly higher estimated glomerular filtration rate (eGFR) at last follow-up compared with late remitters. Accordingly, patients with CKD at last follow-up had statistically longer time to remission. Among patients who achieved remission, 32% relapsed, with a negative impact on renal outcome, that is, lower eGFR values and higher proportion of CKD (33% vs 8%).ConclusionEarly remission should be achieved to better preserve long-term renal function.

scholarly journals Parathyroidectomy Versus Cinacalcet for the Treatment of Secondary Hyperparathyroidism in Hemodialysis Patients

2022 ◽  
Author(s):  
Luis Alvarado ◽  
Nishtha Sharma ◽  
Roxann Lerma ◽  
Alok Dwivedi ◽  
Adeel Ahmad ◽  
...  
Keyword(s):  
Propensity Score ◽  
Secondary Hyperparathyroidism ◽  
Propensity Score Matching ◽  
Cox Regression ◽  
The United States ◽  
Hemodialysis Patients ◽  
Cox Regression Analysis ◽  
Pathologic Fractures ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Secondary hyperparathyroidism in patients with end stage renal disease on dialysis is associated with bone pain and fractures in addition to cardiovascular morbidity. Cinacalcet is the most commonly used drug to treat such patients, but it has never been compared to surgery. The goal of this study is to compare the long-term outcomes and survival between cinacalcet and parathyroidectomy in the treatment of secondary hyperparathyroidism in hemodialysis patients. Methods Adult patients on hemodialysis who were treated with cinacalcet or parathyroidectomy in the United States Renal Data System were included. Patients treated with surgery (n = 2023) were compared using 1:1 propensity score matching ratio to a cohort of patients treated with cinacalcet. A Cox regression analysis was conducted to compare the overall mortality. Results The propensity score matching successfully created two groups with similar demographics. Patients in the surgery group had a higher mean peak PTH level prior to therapy (2066.8 vs 1425.4, P < 0.001). No difference was observed in the development of new-onset coronary artery disease (7.7% vs 7.9%, P = 0.8) or cerebrovascular disease (7% vs 6.7%, P = 0.8). Surgical patients had a higher rate of pathologic fractures (27.8% vs 24.9%, P = 0.04). Survival analysis showed that patients undergoing surgery had a better 5-year survival (65.6% vs 57.8%) and were less likely to die within the study period (HR 0.77, 95% CI 0.7–0.85, P < 0.0001). Conclusions Patients on dialysis undergoing parathyroidectomy for the treatment of secondary hyperparathyroidism have a better overall survival than those treated with cinacalcet.

Sustained complete renal remission is a predictor of reduced mortality, chronic kidney disease and end-stage renal disease in lupus nephritis

Lupus ◽  
2017 ◽  
Vol 27 (3) ◽  
pp. 468-474 ◽  
Author(s):  
R Pakchotanon ◽  
D D Gladman ◽  
J Su ◽  
M B Urowitz
Keyword(s):  
Lupus Nephritis ◽  
Renal Disease ◽  
Serum Creatinine ◽  
End Stage Renal Disease ◽  
Renal Outcome ◽  
Renal Flare ◽  
Group A ◽  
Group B ◽  
Stage Renal Disease ◽  
End Stage

Objective The objective of this paper is to identify the relationship between patients with lupus nephritis (LN) who achieve sustained complete renal remission (CR) and renal outcome and survival. Methods From a longitudinal cohort study we identified patients with LN with CR. We compared the outcomes of patients who achieved sustained CR for at least five years (Group A) with those less than five years (Group B). The outcomes were death, SLICC/ACR damage index (SDI), renal flare, end-stage renal disease (ESRD) or estimated glomerular filtration rate (eGFR) < 50 ml/min, and doubling of serum creatinine. Regression analyses were used to identify predictors of the outcomes. Results A total of 345 patients were identified, 132 patients in Group A and 213 patients in Group B. The duration of CR in Group A was 11.76 ± 7.34 years but only 1.24 ± 1.24 years in Group B ( p < 0.001). Death, increasing renal SDI, renal flare, renal transplantation, ESRD or eGFR < 50 ml/min, and doubling of serum creatinine in Group A were significantly lower than Group B. Multivariable analysis revealed that Group A patients were at a lower risk of death (hazard ratio (HR) = 0.20; 95% confidence interval (CI), 0.07–0.61; p = 0.004), increasing renal SDI (HR = 0.41; 95% CI, 0.21–0.76; p = 0.01), developing ESRD or eGFR < 50 ml/min (HR = 0.27; 95% CI, 0.12–0.61; p = 0.001), and doubling of serum creatinine (HR = 0.29; 95% CI, 0.14–0.61; p = 0.001) compared with Group B. Conclusion Sustained CR for at least five years is a predictor of better prognosis in patients with LN.

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