ISSN: 2251-8363    eISSN: 2251-8819  
J Nephropathol. 2018;7(4):233-240.
doi:10.15171/jnp.2018.48

Original Article

Consecutive renal biopsy in a cohort of patients with lupus nephritis of the Colombian Caribbean

Gustavo Aroca-Martínez * ORCiD, Henry J González-Torres ORCiD, Jackeline Mendoza-Jaimes, Alex Dominguez-Vargas, Álvaro A Martinez-Bayona ORCiD, Elkin Navarro-Quiroz ORCiD, Raúl García-Tolosa, Luis Castillo-Parodi, Carlos G Musso ORCiD, Andrés Cadena-Bonfanti

1 Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla, Colombia
2 Clínica de la Costa, Nefrología, Facultad de Ciencias de la Salud, Barranquilla, Colombia
3 Fundación Lupus del Caribe (FunLuCar), Barranquilla, Colombia
4 Hospital Italiano, Unidad de Biología del Envejecimiento, Buenos Aires, Argentina
*Corresponding author: Gustavo J. Aroca-Martinez, MD, PhD; Email: Email: garoca1@unisimonbolivar.edu.co

Abstract

Background: Renal biopsy is the gold standard for the diagnosis and classification of lupus nephritis (LN). However, a consecutive biopsy can predict the clinical course and optimize the therapeutic strategies.

Objectives: To compare the histopathological findings with clinical responses.

Patients and Methods: Thirty patients with active LN were included. Renal biopsies were performed at the time of diagnosis and subsequently under clinical criteria according to consensus of Spanish Society of Nephrology. The response to treatment was defined as complete response, partial responder or non-responder. The histological change in second biopsy towards LN classes I, II or III/IV-C was defined as histological response (HR).

Results: In initial renal biopsy, 28 (93%) patients showed proliferative LN; III-A or A/C (n; 7), IV-A or A/C (n: 19) and mixed; III+IV/V (n; 2). LN class V was presented in two cases. The clinical response was; complete response (10%), partial response (20%), and non-response (70%). HR was manifested in 37% and non-histologic response in 63% of patients. Around 33% of patients with complete response/partial response showed active lesions in the consecutive renal biopsy.

Conclusions: In Colombian Caribbean, LN is aggressive and refractory to treatment. The consecutive renal biopsy allowed to demonstrate the persistence of the activity of the lesion in almost half of the patients, which may provide additional information to create better response criteria. The consecutive renal biopsy is a tool that allows improving the evaluation of the response to treatment in the LN.

Implication for health policy/practice/research/medical education:

This research presents evidence on the need to protocolize the consecutive biopsy to incorporate the results of the histopathology to the clinical follow-up of the patient.

Please cite this paper as: Aroca-Martínez GJ, Mendoza-Jaimes J, Gonzalez-Torres HJ, Dominguez-Vargas A, Martinez-Bayona Á, Navarro-Quiroz E, et al. Consecutive renal biopsy in a cohort of patients with lupus nephritis of the Colombian Caribbean. J Nephropathol. 2018;7(4):233-240. DOI: 10.15171/jnp.2018.48.

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