Table 3.
Post-treatment Kidney Biopsies Performed in 20 Patients With Lupus Nephritis From a Mexican Cohort Due to Nonresponse to Therapy
| Indication for First Biopsy | ISN-RPS LN Class Biopsy 1 | Activity Index | Chronicity Index | Indication for Second Biopsy | Time Interval (months) | ISN-RPS LN Class Biopsy 2 | Activity Index | Chronicity Index | Immunosuppressive Therapy Modification |
|---|---|---|---|---|---|---|---|---|---|
| Diagnosis | IV-A + V | 14 | 2 | Nonresponder | 6 | IV-A | 16 | 7 | Intensification |
| Diagnosis | IV-A | 20 | 0 | Nonresponder | 10 | VI | 1 | 12 | Decrease |
| Diagnosis | IV-A + V | 17 | 0 | Nonresponder | 6 | IV-A/C + V | 5 | 9 | Intensification |
| Diagnosis | IV-A + V | 16 | 5 | Nonresponder | 9 | IV-A/C + V | 8 | 8 | Intensification |
| Diagnosis | IV-A/C + V | 9 | 8 | Nonresponder | 7 | IV-A/C + V | 4 | 10 | Decrease |
| Diagnosis | IV-A/C | 12 | 7 | Nonresponder | 7 | IV-C | 1 | 9 | Decrease |
| Diagnosis | IV-A + V | 5 | 3 | Nonresponder | 7 | IV-A/C + V | 7 | 9 | Intensification |
| Diagnosis | III-A/C | 3 | 6 | Nonresponder | 11 | IV-C + V | 2 | 9 | Decrease |
| Diagnosis | V | 1 | 3 | Nonresponder | 8 | III-C + V | 1 | 3 | Change to another agent |
| Diagnosis | IV-A + V | 12 | 6 | Nonresponder | 3 | IV-C + V | 3 | 10 | Decrease |
| Diagnosis | IV-A/C | 7 | 4 | Nonresponder | 12 | IV-C | 1 | 10 | Decrease |
| Diagnosis | III-A + V | 7 | 1 | Nonresponder | 12 | IV-A/C + V | 3 | 10 | Intensification |
| Diagnosis | IV-A/C + V | 5 | 6 | Nonresponder | 8 | IV-A/C + V | 6 | 7 | Intensification |
| Diagnosis | IV-A/C + V | 3 | 6 | Nonresponder | 16 | IV-A/C + V | 6 | 7 | Intensification |
| Diagnosis | IV-A + V | 5 | 3 | Nonresponder | 6 | IV-A + V | 12 | 5 | Intensification |
| Diagnosis | IV-A/C + V | 9 | 7 | Nonresponder | 6 | IV-A/C + TMA | 8 | 10 | No change + total anticoagulation |
| Diagnosis | IV-A + V | 15 | 5 | Nonresponder | 10 | IV-A/C + V | 5 | 10 | Decrease |
| Diagnosis | IV-A + V | 3 | 3 | Nonresponder | 12 | IV-C + V | 1 | 6 | Decrease |
| Diagnosis | IV-A/C + V | 3 | 8 | Nonresponder | 12 | IV-C + V | 1 | 6 | Decrease |
| Diagnosis | IV-A + V | 14 | 3 | Nonresponder | 10 | IV-C + V | 1 | 10 | Decrease |
Notes: Intensification included increasing dose of glucocorticoids and other immunosuppressive agents such as mycophenolate mofetil, cyclophosphamide, calcineurin inhibitors, or B cell-directed therapies.
Abbreviations: ISN-RPS, International Society of Nephrology/Renal Pathology Society; LN, lupus nephritis; SLE, systemic lupus erythematosus.