The objective of this study is to determine the predictive risk factors of failure to achieve remission within 12 months in a group of patients with proliferative
lupus nephritis from Northwestern Colombia. Pragmatic clinical study with retrospective analysis was conducted. We included subjects with
systemic lupus erythematosus as defined by the American College of Rheumatology with biopsy-proven
nephritis. We assessed 149 patients, with 84 % female. Age at diagnosis of
systemic lupus erythematosus is 24.7 years (16-31). The time between diagnosis of lupus erythematosus and proliferative
nephritis is 2 months (0-35.5). ISN/RPS 2003 histologic classification types are the following: IV (63.8 %), III (13.4 %), V + III (3.3 %), and V + IV (3.3 %). Activity index is 6.18 ± 4.55 and chronicity index is 1 (0-3). The result of 24-h
proteinuria is 2000 mg (667-4770) and baseline
creatinine is 0.9 mg/dL (0.7-1.3). Induction
therapy includes
corticosteroids (100 %),
cyclophosphamide (74.1 %), and
mycophenolate mofetil (25.9 %). At 12 months, 40.7 % of individuals failed to attain partial or complete remission. Elevated
creatinine (p = 0.0001) and 24-h
proteinuria greater than 1500 mg (p = 0.0011) were basal predictors of failure to attain partial or complete remission by bivariate analysis. Similar results were obtained in multivariate analysis: Baseline
creatinine elevation (OR 3.62, 95 % CI, 1.59-8.23; p = 0.002) and 24-h
proteinuria greater than 1500 mg (OR 3.62, 95 % CI, 1.29-10.13; p = 0.014) were independent predictors of failure to achieve partial or complete remission. At 12 months, 40.7 % of patients did not attain partial or complete remission. Baseline elevated
creatinine and 24-h
proteinuria over 1500 mg were predictors for poor response.