Faurschou et al identified risk factors for progression to renal failure in a patient with lupus nephritis. This can help identify a patient who may benefit from more aggressive management. The authors are from the National University Hospital of Copenhagen and Vejle Hospital in Denmark.
Findings of nephritis are:
(1) persistent proteinuria (> 500 mg per day)
(2) hematuria
(3) presence of cellular casts
Parameters identified on multivariate analysis:
(1) duration of nephritis symptoms prior to renal biopsy
(2) serum creatinine in µmol/L
(3) histologic pattern of lupus glomerulopathy
(4) tubular atrophy
Parameter |
Finding |
Points |
duration of nephritis |
<= 6 months |
0 |
|
> 6 months |
1 |
serum creatinine |
<= 140 µmol/L (1.58 mg/dL) |
0 |
|
> 140 µmol/L |
1 |
histologic pattern |
diffuse proliferative |
1 |
|
other |
0 |
tubular atrophy |
absent |
0 |
|
present |
1 |
total number of risk factors =
= SUM(points for all 4 parameters)
Interpretation:
• minimum number: 0
• maximum number: 4
• The higher the number of risk factors the greater the risk of terminal renal failure.
• Early diagnosis and aggressive treatment can preserve renal function. Delayed diagnosis and/or therapy may result in terminal renal failure.
Purpose: To identify risk factors for progression to terminal renal failure in a patient with lupus nephritis based on the study of Faurschou et al.
Specialty: Nephrology, Clinical Laboratory, Immunology/Rheumatology
Objective: severity, prognosis, stage
ICD-10: M32.1,