Use of serial renal biopsies in lupus nephritis
Abstract
Introduction: In our working environment, lupus nephritis remains the leading autoimmune cause of terminal chronic kidney disease requiring renal function replacement. There is little literature on the use of a serial biopsy in this population. Objective: Our objective was to assess the renal function of patients with serial renal biopsies at 1 year of follow-up, compared with patients who had only one baseline biopsy. Methods: An observational, comparative, longitudinal and retrospective study in patients with lupus nephritis who underwent at least one renal biopsy between January 2004 and January 2012. Results: 100 patients with lupus nephritis were included, r7 with serial biopsy and 43 without serial biopsy. The population without a serial biopsy had a greater proportion of patients with impaired renal function (58.1% vs. 41.9%) and a higher proportion of dialysis patients at 1 year followup compared to the serial biopsy group (90% vs. 10%, p=0.002). In the serial biopsy group, the immunosuppressive regime was modified in 80.7% depending on the outcome of the renal biopsy serial. Of these, 57.9% of patients received either a more aggressive immunosuppressive treatment or a new scheme. Conclusions: the usefulness of a serial renal biopsy in patients with lupus nephritis lies in allowing
for timely changes in immunosuppression, which may help to slow the progression of kidney damage in this risk population.
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