Comparison Study on the Effect of Treatment Decision Based on Renal Biopsy and Clinical Symptoms in the Outcome of Patients with Recurrent Lupus Nephritis

Renal involvement in systemic lupus erythematous is one of the most serious complications. The aim of this study was to compare the effects of treatment decisions based on clinical symptoms and renal biopsy on the outcome of patients with recurrent lupus nephritis.

This descriptive study was conducted in 2012–13 in the Alzahra hospital on patients with lupus nephritis who had referred to the rheumatology clinic of this center due to lupus nephritis relapse. All lupus nephritis patients were diagnosed with renal biopsy and had gone into remission by treatment but due to the discontinuation of treatment and other causes had relapsed. The patients were divided randomly into two groups of 26, the fi rst group was treated without renal biopsy and based on clinical and laboratory symptoms and the second group was re-biopsied through considering the ethical points. Then their relationship with laboratory fi ndings (BUN, Cr, ANA, ds-DNA, C3, C4, CH50, U/A, cast, and proteinuria), treatment and recurrence outcome were compared between the two groups.

The mean of SLEDAI-2K index before initial treatment, after the fi rst round of treatment and after the second round of treatment in single biopsy group and twice biopsy group is not signifi cantly different (P = 0.27).

Treatment decisions based on clinical and laboratory fi ndings or re-biopsy of the kidney in patients who relapsed after initial treatment had no signifi cant effect on the recovery of patients. Adoption of a treatment plan in patients with lupus nephritis is recommended based on clinical and laboratory fi nding and the discretion of the physician and if possible, kidney re-biopsy should be avoided.