Published in:
Open Access
01-12-2018 | Letter
Early achievement of deep remission predicts low incidence of renal flare in lupus nephritis class III or IV
Authors:
Hironari Hanaoka, Harunobu Iida, Tomofumi Kiyokawa, Yukiko Takakuwa, Kimito Kawahata
Published in:
Arthritis Research & Therapy
|
Issue 1/2018
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Excerpt
Recommendations for lupus nephritis (LN) management specify that the therapeutic target should be a complete renal response (CR) [
1], defined as a urine protein:Cr ratio (UPCR) of 0.5 g/gCr (50 mg/mmol) and normal or near-normal renal function. Earlier studies suggested that patients who achieved CR experienced fewer renal flares than those who achieved partial remission, defined as a 50% reduction of proteinuria [
2]. Among patients who achieved CR (less than 0.50 g/gCr of UPCR), however, the renal outcome of those who achieved a value below the normal UPCR limit of 0.15 g/gCr was unclear. We recently reported that an early renal response may predict a good renal or systemic outcome [
3,
4]. In this study, we investigated whether it is beneficial to achieve deep remission early by evaluating flare rate, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), cumulative glucocorticoid dose, and eGFR level. …