Abstract:

ABSTRACT Objective: To observe the long-term renal outcome of Chinese patients with lupus nephritis (LN) and detect risk factors for poor renal outcome. Methodology: The records of all patients with biopsy-proven lupus nephritis followed for at least one year were reviewed. One thousand eight hundred and fourteen patients were included this respective syudy. All patients were pathological classified based on ISN/RPS 2003 classification, 127（7.0%）patients with class Ⅱ, 244（13.5%）with class Ⅲ, 202（11.1%）with class Ⅲ+Ⅴ, 711（39.2%）with class Ⅳ, 284（15.7%）with class Ⅳ+Ⅴ, 246（13.6%）with class Ⅴ.The end point was end stage renal disease (ESRD). Results: They were 253 (13.9%) males and 1561 (86.1%) females with an average follow-up times of 93.3±60.4 months. The 5-, 10-, 15-, 20-, and 25-year renal survival rates were 93.1%、87.9%、81.0%、68.3%、58.7%, respectively. Gender, LN duration, mean arterial pressure (MAP), proteinuria, serum creatinine, hemoglobin, serum complement C4 and pathological classification were independent baseline risk factors for ESRD. Time average proteinuria (TA-Pro) and time average mean arterial pressure (TA-MAP) were both independent follow-up risk factors for ESRD, with better predictive values than baseline proteinuria and MAP respectively. Conclusions: The 10-year and 20-year renal survival rates of LN patients were 87.9% and 68.3% respectively. Pathological classification was associated with renal outcome, class Ⅳ and class Ⅳ+Ⅴ LN predicting poor renal outcome. Control of proteinuria and MAP during follow-up was important for improving renal outcome.