Document Detail


Predictive value of clinical, laboratory, pathologic, and treatment variables in steroid/immunosuppressive resistant lupus nephritis.
MedLine Citation:
PMID:  3391988     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Twenty-seven patients with lupus nephritis and nephrotic syndrome had persistent disease activity despite an adequate trial of corticosteroids and immunosuppressive drugs; 30% were Asians, compared with 7% of our overall SLE population. Two years later, seven had a very good outcome and seven a poor outcome. Thirty clinical, pathological, laboratory, and treatment variables were analyzed in a good versus poor responder subset comparison in an effort to determine which factors were associated with favorable outcome. Administration of pulse steroids (P = .069) and a low biopsy chronicity index (P = .048) were associated with the good responder subset. Serum creatinine, biopsy class, blood pressure, complement, and anti-DNA values at entry as well as the choice of immunosuppressive drug were not helpful in predicting outcome. All seven good responders were plasmapheresed (P = .026). Patients with refractory lupus nephritis who have a low biopsy chronicity index may benefit from the use of pulse steroids or plasmapheresis, and controlled studies are suggested.
Authors:
D J Wallace; D Goldfinger; G Savage; S Nichols; D Goodman; M Fichman; M Stewart; J R Klinenberg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical apheresis     Volume:  4     ISSN:  0733-2459     ISO Abbreviation:  J Clin Apher     Publication Date:  1988  
Date Detail:
Created Date:  1988-08-19     Completed Date:  1988-08-19     Revised Date:  2005-07-26    
Medline Journal Info:
Nlm Unique ID:  8216305     Medline TA:  J Clin Apher     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  30-4     Citation Subset:  IM    
Affiliation:
Department of Medicine, UCLA School of Medicine.
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MeSH Terms
Descriptor/Qualifier:
Adult
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Glucocorticoids / administration & dosage*
Humans
Immunosuppressive Agents / administration & dosage*
Lupus Nephritis / metabolism,  pathology,  therapy*
Male
Nephrotic Syndrome / metabolism,  pathology,  therapy*
Plasmapheresis / methods*
Prognosis
Chemical
Reg. No./Substance:
0/Glucocorticoids; 0/Immunosuppressive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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