Table 1.
Patient demographics and clinical data
| Lupus nephritis class III (n=11) |
Lupus nephritis class IV (n=23) |
Lupus nephritis class V (n=21) |
Thin basement membrane (n=14) | Membranous nephropathy (n=9) | |
| Female/male (%F) | 11/0 (100%) | 23/0 (100%) | 21/0 (100%) | 13/1 (92.9%) | 5/4 (55.6%) |
| Age of patient at time of kidney biopsy (years) | 33 (16–58) | 36 (22–48) | 36 (19–57) | 38.5 (16–67) | 53 (42–73) |
| Disease duration at time of kidney biopsy (years) | 0 (0–17) | 8 (0–28) | 5 (0–32) | ||
| First kidney biopsy—number (%) | 10 (91%) | 13 (57%) | 9 (43%) | ||
| Ethnicity—number (%) | |||||
| Caucasian | 2 (18%) | 7 (30%) | 3 (14%) | 4 (28.6%) | 3 (33.3%) |
| Black | 5 (45%) | 7 (30%) | 11 (52%) | 1 (7.1%) | 0 (0%) |
| East Asian | 2 (18%) | 8 (35%) | 5 (24%) | 3 (21.4%) | 4 (44.4%) |
| South Asian | 0 | 0 | 1 (5%) | 6 (42.9%) | 2 (22.2%) |
| Other | 2 (18%) | 1 (4%) | 1 (5%) | ||
| Renal function at time of kidney biopsy: | |||||
| Serum albumin—g/L (NR 35–50) | 32 (20–41)† | 21 (12–35)‡ | 28 (13-40)§ | 37 (31–47) | 31 (16–40)¶ |
| Serum creatinine—micromol/l (NR 55–110) | 70 (41–135) | 95 (53–310)†† | 61 (45–146) | 64 (55–179) | 80 (56–180) |
| eGFR—mL/min/1.73 m2 (NR >89) | 76 (50–90) | 64 (14–90)‡‡ | 90 (32–90) | 90 (25–90) | 79 (24–90) |
| Urine protein:creatinine ratio—mg/mmol (NR <30) | 82 (37–404) | 666 (150–2414)§§ | 307 (0–1463) | 10 (0–443) | 552 (297–729) |
| Age of kidney biopsy at time of analysis (years) | 3.55 (0.11–9.7) | 4.7 (0.3–11.54) | 4.34 (1.32–10.72) | 3.1 (0.2–5) | 1.2 (1–4.6) |
| Number of glomeruli | 16 (9–29) | 13 (8–30) | 17 (7–37) | 16.5 (7–32) | 15 (6–26) |
| Number of active glomeruli | 4 (1–7) | 11 (1–25) | 0 (0) | 0 | 0 |
| Number of sclerosed glomeruli | 0 (0–4) | 2 (0–10) | 1 (0–9) | 1.5 (0–5) | 1 (0–8) |
| Number of glomeruli with crescents | 0 (0–2) | 2 (0–10) | 0 (0) | 0 | 0 (0–1) |
| Number of glomeruli with thrombosis | 0 (0–1) | 0 (0) | 0 (0) | 0 | 0 |
| Number of glomeruli with necrosis | 5 (45%) | 1 (4.3%) | 0 (0%) | 0 | 0 |
| Acute tubular injury or tubulitis—number (%) | 5 (45%) | 16 (70%) | 9 (43%) | 0 | 0 |
| Tubuloreticular inclusions—number (%) | 10 (91%) | 18 (78%) | 17 (81%) | 0 | 1 (11.1%) |
| Interstitial fibrosis and tubular atrophy (%) | 0 (0–20; n=3) | 5 (0–40; n=13) | 5 (0–25; n=11) | 2.5 (0–10) | 10 (0–50) |
| C3 g/L (NR 0.7–1.7) | 0.52 (0.22–0.76) | 0.6 (0.23–1.22) | 1.09 (0.49–1.82)¶¶ | ||
| C4 g/L (NR 0.16–0.54) | 0.06 (0–0.25) | 0.09 (0.03–0.22) | 0.19 (0.07–0.46)††† | ||
| dsDNA IU/mL (NR 0–30) | 2041 (248–20171) | 275 (17–5789)‡‡‡ | 41 (0–723)§§§ | ||
| Treatment | |||||
| First biopsy (number) | 10 | 13 | 9 | ||
| MMF and RTX | 10 (100%) | 11 (85%) | 4 (44%) | ||
| CYC and RTX | 0 | 1 (8%) | 1 (11%) | ||
| MMF and HCQ | 0 | 1 (8%) | 1 (11%) | ||
| Other | 0 | 0.0 | 3 (33.3%) | ||
| Previous biopsy (number) | 1 | 10 | 12 | ||
| MMF and RTX | 0 | 1 (10%) | 3 (25%) | ||
| CYC and RTX | 0 | 1 (10%) | 2 (17%) | ||
| CYC | 1 (100%) | 6 (60%) | 0 | ||
| RTX added to MMF | 0 | 1 (10%) | 7 (58%) | ||
| MMF | 0 | 0 | 0 | ||
| No Rx escalation | 0 | 1 (10%) | 0 | ||
| Response | |||||
| Complete/partial/non-response | 9 (82%)/1 (9%)/1 (9%) | 10 (43%)/0/13 (57%) | 11 (52%)/3 (14%)/7 (33%) |
Values represent median (range of values) or number (%).
†* vs TBM.
‡**** vs TBM and ** vs class III.
§**** vs TBM.
¶** vs TBM.
††* vs class III and *** vs class IV.
‡‡** vs class IV.
§§*** vs class III and ** vs class V and **** vs TBM
¶¶**** vs class III or class IV.
†††*** vs class III or class IV.
‡‡‡* vs class III.
§§§** vs class III.
*P≤0.05, **p≤0.01, ***p≤0.001, ****p≤0.0001 derived from ANOVA with Sidak’s multiple comparisons test.
ANOVA, analysis of variance; CYC, cyclophosphamide; eGFR, estimated glomerular filtration rate; HCQ, hydroxychloroquine; MMF, mycophenolate mofetil; NR, normal range; RTX, rituximab; TBM, thin basement membrane.