Repeated Renal Biopsy – A Predictive Tool to Assess the Probability of Renal Flare in Lupus Nephritis

Background: How one responds to treatment of lupus nephritis (LN) is based on clinical features, but the activity in renal biopsy (RB) is uncertain. We have described the therapeutic decisions after performing a repeated RB on the assessment of response to intravenous cyclophosphamide (IC) and the possible prognostic role of this repeated RB. Methods: Clinical, laboratory and histological features at the initial RB and repeated RB were analyzed in 35 patients. Results: Data in the initial versus the repeated RB were serum creatinine 1.23 ± 1.08 and 0.96 ± 0.45 mg/dl (p < 0.05), glomerular filtration rate <60 ml/min in 12 and 5% patients and proteinuria 4.1 ± 2.8 vs. 0.6 1.1 g/day (p < 0.05). Significant differences were detected in hematuria, nephrotic syndrome and serological immune features. Complete renal remission was reached in 60% (n = 21) at the time of the repeated RB, partial remission in 31.4% (n = 11), and no response IC in 8.6% (n = 3). Nine patients showed proliferative forms in the repeated RB, 3 of them had proteinuria <1 g/day. Just after the repeated RB, 34.3% increased or Received: July 13, 2016 Accepted: September 30, 2016 Published online: October 28, 2016 Nephrology American Journal of Pilar Arrizabalaga, MD, PhD Department of Nephrology and Renal Transplant Hospital Clínic Villarroel 170, ES–08036 Barcelona, Catalonia (Spain) E-Mail parriza @ clinic.ub.es © 2016 S. Karger AG, Basel 0250–8095/16/0446–0439$39.50/0