Kidney biopsy in systemic lupus erythematosus. III. Survival analysis controlling for clinical and laboratory variables

Abstract

Objective: To examine the importance of renal biopsy as a predictor of death due to any cause in patients with systemic lupus erythematosus (SLE).

Methods: The study included 123 SLE patients who had a renal biopsy between 1970 and 1984 and were followed up as part of a prospective study. Data were initially analyzed to identify clinical and laboratory features that were significantly associated with the risk of dying. Renal biopsy variables were then examined to determine whether they contributed additional information about prognosis.

Results: The clinical and laboratory factors most closely associated with the risk of dying in multivariate analyses were the serum creatinine level and the SLE Disease Activity Index score. The presence of chronic renal lesions on biopsy contributed significantly to the prognostic information offered by clinical and laboratory factors in the subset of patients who had normal serum creatinine levels--the majority (85%) of patients in this study.

Conclusion: These results indicate that renal biopsy serves an important role in the assessment of prognosis in patients who do not have advanced renal disease.