Description

Austin et al identified histologic features associated with renal failure in lupus patients with proliferative glomerulonephritis. These can help to identify a patient who may benefit from more aggressive management. The authors are from the National Institutes and the Armed Forces Institute of Pathology.


Patient selection: lupus nephritis, diffuse proliferative or membranoproliferative

 

A patient with diffuse proliferative or membranoproliferative glomerulonephritis is more likely to develop renal failure than other types of lupus nephritis (focal proliferative, membranous, mesangial).

 

Criteria for high risk group - all of the following:

(1) tubular atrophy

(2) glomerular sclerosis

(3) cellular crescents

 

After 5 years about 75% of patients had progressed to renal failure (in 1984).

 

A patient who was not high risk classified as low risk.


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