Renal Pathology and Long-term Outcome in Childhood SLE

ACHRA SUMBOONNANONDA, M.D.*, VIBUL SUNTORNPOCH, M.D.*, PAISAL PARICHATIKANOND, M.D.** ARUN VONGJIRAD, M.D.*, TAWEE LAOHAPAND,M.D.**,

Affiliation : * Department of Pediatrics ** Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. t Presented at the XIVth International Congress of Nephrology, 25-29 May 1997, Sydney, Australia.

Abstract Renal histology is increasingly used as a guide for therapy and prognosis m SLE but data in children are few and/or short-term. We assessed renal histological features in 19 children with SLE to determine whether these features are useful in predicting long-term outcome. Mean age at biopsy was 10±1.7 years old, male to female ratio was 1:2.8. Fourteen patients (73%) had diffuse proliferative lupus nephritis. Renal histology was evaluated using an activity index (AI) and chronicity index (CI). Clinical assessment of renal function at biopsy and outcome were graded according to urinalysis and serum creatinine. Renal function at biopsy correlated well with AI (p We conclude that although AI correlates well with renal function at biopsy and CI with short-term prognosis, neither can predict long-term outcome. Treatment may have altered the natural course of disease in these patients.

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