Goulet et al identified risk factors associated with outcome in patients with lupus nephritis. These can help identify patients who may require more aggressive therapy and closer monitoring. The authors are from McGill and Yale Universities.
Outcomes:
(1) renal insufficiency (serum creatinine > 5.0 mg/dL)
(2) renal failure
(3) renal SLE death
(4) any SLE death
Outcome was displayed as CART (Classification and Regression Tree) using the RECPAM (recursive partition and amalgamation) algorithm.
Parameters:
(1) prior duration of renal disease
(2) nephrotic syndrome
(3) 24 hour urinary protein excretion (in gram per 24 hour)
(4) le Riche index (from 0 to 11.94)
(5) serum creatinine (in mg/dL)
|
Prior Duration of Renal Disease |
Nephrotic Syndrome |
le Riche Index |
Rate of Renal Insufficiency |
|
>= 22 months |
NA |
NA |
high rate (7.2) |
|
< 22 months |
present |
NA |
intermediate rate (4.7) |
|
< 22 months |
absent |
>= 4.2 |
intermediate rate (3.0) |
|
< 22 months |
absent |
< 4.2 |
low rate (0) |
where:
• The rate is expressed in patients per 1,000 patient months of observation
|
24 Hour Urinary Protein Excretion |
le Riche Index |
Rate of Renal Failure |
|
>= 2.6 g |
NA |
intermediate rate (2.9) |
|
< 2.6 g |
>= 4.1 |
intermediate rate (2.6) |
|
< 2.6 g |
< 4.1 |
low rate (0) |
|
Prior Duration of Renal Disease |
le Riche Index |
Rate of Renal SLE Death |
|
>= 22 months |
NA |
high rate (6.9) |
|
< 22 months |
>= 4.1 |
intermediate rate (2.9) |
|
< 22 months |
< 4.1 |
low rate (0.3) |
|
Serum Creatinine |
le Riche Index |
Rate of Any SLE Death |
|
>= 1.5 mg/dL |
NA |
high rate (7.0) |
|
< 1.5 mg/dL |
>= 4.9 |
intermediate rate (4.5) |
|
< 1.5 mg/dL |
< 4.9 |
low rate (0.7) |
Specialty: Nephrology, Clinical Laboratory, Immunology/Rheumatology
