Comparison of long-term outcomes of patients with systemic lupus erythematosus developing proliferative or nonproliferative lupus nephritis

Systemic lupus erythematosus (SLE) is an autoinflammatory disease that can involve many organs and systems with exacerbations and remissions. Genetic factors, environmental agents, hormonal factors and some autoantibodies have been implicated in its pathogenesis. An important cause of morbidity and mortality in SLE is lupus nephritis. Classification of lupus nephritis (LN) is an important factor in treatment regimen and prognosis. In our study, we aimed to compare the retrospective long- term results of 55 patients with LN followed in our clinic. Demographic characteristics, family histories, symptom and clinical findings, imaging, laboratory findings, kidney biopsy results, treatment regimens and long-term results of patients with nephritis were examined. Class 4 LN was the most common among our patients. It was noted that more proliferative lupus nephritis developed in male patients, less complete remission in proliferative lupus nephritis, more relapse and progression to end-stage renal disease (ESRD). All patients with progressive ESRD were in the proliferative group. While good long-term results were obtained in the class 2 and 5 LN noproliferative group in our lupus nephritis patients who were treated with standard treatment regimens, ESRD progressed at a rate of 12% in patients with proliferative LN despite anti- inflammatory and immunosuppressive therapy. It was thought that more positive long-term results could be obtained with the development of new treatment regimens by elucidating the etiopathogenesis of proliferative LN. Key Words: lupus nephritis, prognosis in lupus nephritis, treatment in lupus nephritis