Consecutive renal biopsy in a cohort of patients with lupus nephritis of the Colombian Caribbean
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Fecha
2018
Autores
Aroca-Martínez, Gustavo J.
Mendoza-Jaimes, Jackeline
Gonzalez-Torres, Henry J.
Dominguez-Vargas, Alex
Martinez-Bayona, Álvaro
Navarro-Quiroz, Elkin
García-Tolosa, Raúl
Castillo-Parodi, Luis
Carlos G., Musso
Cadena-Bonfanti, Andrés
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Editor
Society of Diabetic Nephropathy Prevention
Resumen
Background: Renal biopsy is the gold standard for the diagnosis and classification of lupus
nephritis (LN). However, a consecutive biopsy can predict the clinical course and optimize
the therapeutic strategies.
Objectives: To compare the histopathological findings with clinical responses.
Patients and Methods: Thirty patients with active LN were included. Renal biopsies were
performed at the time of diagnosis and subsequently under clinical criteria according to
consensus of Spanish Society of Nephrology. The response to treatment was defined as
complete response, partial responder or non-responder. The histological change in second
biopsy towards LN classes I, II or III/IV-C was defined as histological response (HR).
Results: In initial renal biopsy, 28 (93%) patients showed proliferative LN; III-A or A/C
(n; 7), IV-A or A/C (n: 19) and mixed; III+IV/V (n; 2). LN class V was presented in two
cases. The clinical response was; complete response (10%), partial response (20%), and
non-response (70%). HR was manifested in 37% and non-histologic response in 63% of
patients. Around 33% of patients with complete response/partial response showed active
lesions in the consecutive renal biopsy.
Conclusions: In Colombian Caribbean, LN is aggressive and refractory to treatment. The
consecutive renal biopsy allowed to demonstrate the persistence of the activity of the
lesion in almost half of the patients, which may provide additional information to create
better response criteria. The consecutive renal biopsy is a tool that allows improving the
evaluation of the response to treatment in the LN.
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Palabras clave
Lupus nephritis, Renal biopsy, Clinical response, Consecutive renal biopsy