Baseline Proteinuria and Serum Creatinine Concentration as Clinical Predictors of Complete Renal Response in Patients with Lupus Nephritis: A Single-Center Experience

Int J Environ Res Public Health. 2022 Nov 29;19(23):15909. doi: 10.3390/ijerph192315909.

Abstract

The aim of the study was to identify robust predictors of complete renal response (CRR), within 36 months, in a single-center cohort of lupus nephritis (LN) patients. Patients with biopsy-confirmed LN who underwent kidney biopsy between 1 January 2010 and 31 December 2020 were included and followed up for at least 6 months. CRR was defined as a reduction of urinary protein-to-creatinine ratio (UPCR) below 0.50 g/g. We evaluated baseline demographic, laboratory, and biopsy characteristics as potential predictors of CRR, and selected the variables further evaluated with Kaplan−Meier curves and log-rank tests. The traits with a p-value < 0.1 were later tested with both uni- and multivariable Cox proportional hazard models. Our sample consisted of 57 patients (84% females, median age 32 years), out of which 63.2% reached CRR within 36 months. The initial UPCR and estimated glomerular filtration rate (eGFR) were the only variables in multivariable Cox regression model, which were selected through backward elimination, with a significance threshold <0.05 (HR = 0.77, p = 0.01 and HR = 1.02, p = 0.001). Our results confirmed the role of initial UPCR and serum creatinine concentration (sCr) as predictors of CRR in LN.

Keywords: lupus nephritis; proteinuria; systemic lupus erythematosus.

MeSH terms

  • Adult
  • Creatinine
  • Female
  • Humans
  • Kidney / pathology
  • Lupus Nephritis* / pathology
  • Male
  • Proteinuria
  • Remission Induction
  • Retrospective Studies

Substances

  • Creatinine

Grants and funding

The study was supported by the Wroclaw Medical University statutory funds (SUB.C160.21.016). This was investigator-initiated research. The funding body had no role in the study design, data collection, analyses, and interpretation, or in writing the manuscript.