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Observational Study
. 2014 Aug;23(9):898-904.
doi: 10.1177/0961203314531841. Epub 2014 Apr 11.

Comparison of renal response parameters for juvenile membranous plus proliferative lupus nephritis versus isolated proliferative lupus nephritis: a cross-sectional analysis of the CARRA Registry

A Boneparth  1 , N T Ilowite  2 ; CARRA Registry Investigators
Collaborators, Affiliations
Observational Study

Comparison of renal response parameters for juvenile membranous plus proliferative lupus nephritis versus isolated proliferative lupus nephritis: a cross-sectional analysis of the CARRA Registry

A Boneparth et al. Lupus. 2014 Aug.

Abstract

Lupus nephritis (LN) affects many patients with juvenile systemic lupus erythematosus (SLE) and is a significant cause of disease morbidity. Membranous plus proliferative LN (M + PLN) may represent a more difficult to treat subtype of juvenile LN, compared to isolated proliferative LN (PLN). In this retrospective observational study, we utilized data from the Childhood Arthritis and Rheumatism Research Alliance (CARRA) registry to compare response rates for pediatric M + PLN versus PLN. Response was assessed at the most recent CARRA registry visit gathered ≥6 months after diagnostic kidney biopsy. Estimated glomerular filtration rate (GFR) less than 90 ml/min/1.73 m(2), indicating renal insufficiency, was found in 16.1% of patients with M + PLN and 6.1% of patients with PLN (P = 0.071). We found no significant difference in achievement of response in either hematuria or proteinuria between PLN and M + PLN groups or between subgroups determined by presence of class III vs. class IV proliferative disease. Exposure rates to mycophenolate, cyclophosphamide, and rituximab were similar between groups. Future studies will be necessary to correlate pediatric LN renal histology data with treatment response as well as other disease outcome measures.

Keywords: CARRA registry; Lupus; membranous; nephritis; pediatric; proliferative; response.

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Figures

Figure 1
Figure 1
Medication Exposures of Patients with Juvenile Lupus Nephritis
Figure 2
Figure 2
Inclusion of CR patients with juvenile LN in response analysis and number of patients achieving response for both hematuria and proteinuria. (R, response; NR, no response)
Figure 3
Figure 3
Comparison of response rates for hematuria and proteinuria in patients with PLN and M+PLN. (A) response of hematuria. (B) response of proteinuria
See this image and copyright information in PMC

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