SP184CLINICAL IMPLICATIONS AND PATHOLOGICAL CLASSIFICATION OF TUBULOINTERSTITIAL INJURY FOR THE PREDICTION OF RENAL OUTCOME IN LUPUS NEPHRITIS

Le résumé fourni par la source

INTRODUCTION AND AIMS: Tubulointerstitial lesions are a common finding in Lupus Nephritis (LN) and impacts in renal outcome independently of glomerular lesions,however the current classification does not include a mandatory score of this kind of injury and there is scarce information about his role in the assessment of treatment response. METHODS:We sought to determine predictors and influence of tubulointerstitial inflammation and fibrosis in renal outcomes and treatment response in a cohort of 82 patients with 100 biopsy proven LN flares, treated in the Hospital Clinic of Barcelona between 2000-2016. RESULTS: Tubulointerstitial chronic damage and inflammation, were present in 74% of the biopsies. Patients with inflammation grade 1 o more ( >25%) had worse renal function and proteinuria than patients with no inflammation.The more fibrosis, the worst renal function, especially when it was more than 50%. Fibrosis >25% was an independent predictor of renal survival, augmented the possibility of reaching stage 4 KDOQI-CKD and having a progressive GFR decline. Acute inflammation correlates with the presence of AKI and hematuria with casts at presentation. Around 40% of patients with clinical remission still had significant inflammation on repeat biopsy CONCLUSIONS: Tubulointerstitial chronic damage and inflammation had an important impact in renal outcomes and is essential in treatment response assessment. A proper evaluation of urine sediment is an important tool to detect early lesions in patients with Lupus nephritis.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.