关键词: 重症狼疮性肾炎, 连续性肾脏替代治疗, 预后

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To explore the predictors and outcome of patients with severe Lupus nephritis (LN) who needed continuous renal replacement therapy (CRRT).
Ｍｅｔｈｏｄｏｌｏｇｙ：Two hundred forty seven LN patients [54 male and 193 female,median age 300(23～41) years] requiring CRRT from January 2009 to December 2016 in Jinling Hospital were included in this study.
Ｒｅｓｕｌｔｓ：3 month after admission,152(615%) patients achieved dialysis independence (dialysis independent group);95(385%) patients were on maintenance dialysis (dialysis dependent group).The multivariate COX regression analysis revealed that longer kidney damage course (P=0047,HR=0997),low albumin level (P=0021,HR=1765),high serum creatinine level (P=0033,HR=0684) and oliguria or anuria (P=0001,HR=0460) were the prognostic factors for renal recovery.Renal biopsy was performed in 137 patients,chronic index (CI)>5 was the independent factor for renal recovery.During a median followup time of 396(143,723) months，26(171%) patients in the dialysis independence group progressed into maintenance dialysis,the 15-8year renal survival were 946 %,755% and 697%,respectively
Ｃｏｎｃｌｕｓｉｏｎ：About forty percent of severe LN patients in this group still need renal replacement therapy after 3 month of treatment.Long kidney damage course,high serum creatinine and low urine output were the independent risk factors for renal survival.