Hiramatsu N et al. - In Class IV-G cases, renal outcome differed in the presence of chronicity in lupus nephritis (LN). Thus, the revised classification of LN is clinically valuable in identifying different renal outcomes among these pts. Methods
Objective was to determine if the International Society of Nephrology/Renal Pathology Society (ISN/RPS) 2003 classification of LN is helpful in predicting renal outcome
92 pts with LN who underwent renal biopsy were re-classified according to the ISN/RPS 2003 criteria
Results
The mean patient age was 36.8 yrs and the median observation period was 65 mos
The relative frequency for each class was as follows: Class I 0%, Class II 13%, Class III 17%, Class IV 60% and Class V 10%
Within Class IV, diffuse segmental was 25% and diffuse global was 75%
During the observation period, renal function was more likely to deteriorate in Class IV-G cases than in Class IV-S cases
Importantly, when Class IV-G was subdivided into cases involving active lesion alone or chronic lesion, the majority of cases in IV-G (A) was nephrotic, but responded well to therapy
In contrast, renal function declined only in IV-G (A/C) cases
Pts with Class IV-G (A/C) had persistent proteinuria in spite of intensified therapies
Moreover, the higher proportion of chronic lesions was related with the deterioration of renal function
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