Clinical presentation and outcome in a cohort of paediatric patients with membranous lupus nephritis

Carl H. Cramer, Michelle Mills, Rudolph P. Valentini, William E. Smoyer, Hillary Haftel, Patrick D. Brophy

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background. Membranous glomerulopathy accounts for 28% of the biopsy-proven systemic lupus erythematosus nephritis in paediatric patients at the time of first biopsy, yet minimal data are available regarding outcomes in this population. Methods. We present a retrospective analysis of 26 paediatric patients with World Health Organization class V lupus nephritis. Patients were subdivided based on renal biopsy findings into the following subclasses: 16 (63%) Va, 2 (9%) Vb, 7 (26%) Vc and 1 (4%) Vd. We evaluated outcomes of renal function and urine protein to creatinine ratio (UPr/UCr). Results. Mean follow-up time was 38.6 (±22) months. Eight patients at presentation had a glomerular filtration rate (GFR) <90 ml/min/1.73 m2, six with Va and two with Vc. The initial presenting serum creatinine was predictive of renal function at last follow-up in class Va and Vb patients (P = 0.002). Twenty-one of the 26 patients had GFR ≥90 ml/min/1.73 m2 at last follow-up; the five patients with GFR <90 ml/min/1.73 m2 were all lupus class Va. Cyclophosphamide (CTX) therapy did not demonstrate a significant improvement in outcome. The following parameters failed to predict GFR at last follow-up visit: blood pressure, C3, C4 and UPr/UCr. Conclusions. The initial creatinine in patients with classes Va and Vb lupus nephritis predicted follow-up renal function. We found no correlation with outcome based on therapy with CTX and/or mycophenolate mofetil.

Original languageEnglish
Pages (from-to)3495-3500
Number of pages6
JournalNephrology Dialysis Transplantation
Volume22
Issue number12
DOIs
StatePublished - Dec 2007

Keywords

  • Membranous nephropathy
  • Paediatrics
  • Systemic lupus erythematosus

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