Medina–Rosas J, et al. – In this assessment, the physicians explored the effect of Complete Recovery (CR), Partial Recovery (PR), and No Recovery (NR) of proteinuria at 2 years from the diagnosis of lupus nephritis (LN) on long–term renal and extra–renal outcomes. They found that CR at 2 years from diagnosis of LN protected against renal outcomes (low eGFR, ESRD/dialysis and transplant). Moreover, CR was more favorable compared to PR. Therefore, clinicians should aim for CR to improve long–term outcomes in LN.

Methods

• This study enrolled patients with LN and proteinuria attending the Lupus Center from 1970–2015.
• At 2 years from diagnosis of LN, patients were divided into 3 groups (CR, PR, NR), and long–term outcomes were studied up to 15 years or last visit available.
• CR was defined as resolution of proteinuria, PR as a reduction ≥ 50% in baseline proteinuria, and NR as a reduction < 50% compared to baseline.
• Long–term outcomes examined included renal outcomes [low eGFR, ESRD, and composite renal (low eGFR, ESRD, and dialysis/transplant)], cardiovascular outcomes, damage, and death.
• To investigate the effect of CR, PR or NR on long–term outcomes, Kaplan–Meier plots, time–independent and time–dependent Cox proportional hazards models were used.

Results

• Out of 277 patients, 71.8% achieved CR, 18.4% PR, and 9.8% NR at 2 years.
• CR compared to NR and CR compared to PR were protective against low eGFR and composite renal outcome in time–independent and dependent analyses.
• In the time–independent analysis, CR compared to PR protected against damage.
• The comparison of CR and PR favored CR for long–term renal outcomes.