medwireNews: A substantial proportion of patients with lupus nephritis from a US study continued to accrue renal damage despite being classified as having a complete response to standard therapy based on proteinuric criteria.
As outlined in a poster presented at the ACR Convergence 2021 virtual meeting, 29.7% of 37 people diagnosed with their first episode of class III, IV, and/or V lupus nephritis experienced progressive renal damage – defined as annual loss of estimated glomerular filtration rate (eGFR) of more than 5 mL/min per 1.73m2 – during the subsequent 5 years of follow-up despite standard-of-care therapy.
Emma Weeding and colleagues, from the Johns Hopkins University School of Medicine in Baltimore, Maryland, found that 55% of these 11 people with progressive renal damage were classified as “complete responders” 1 year after biopsy according to proteinuria levels of less than 500 mg/g.
Moreover, “an alarming” 33% of the 18 patients classified as complete responders at 1 year experienced progressive eGFR decline in the 5 years after biopsy despite resolution of proteinuria, reported Weeding.
These findings indicate that “proteinuria can fail to identify patients who continue to rapidly accrue renal damage,” she said.
And the presenter concluded: “Better definitions and biomarkers of renal response are needed to improve long term outcomes in lupus nephritis as well as clinical trial design.”
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