FRI0106 The assessment of glomerular filtraton rate during the treatment of patients with lupus nephritis

Background The deterioration of renal function is one of the most important prognostic predictors in lupus nephritis (LN). Objectives To determine glomerular filtration rate (GFR) in patients (pts) with LN and to clarify the characteristics of renal haemodynamics during the treatment of LN. Methods Thirty three clinically active pts with LN underwent glomerular filtration rate (GFR) clearance study by using radionucleotide compound Tc-99 m diethylamine-pentoacetic acid (DTPA). All pts had definite clinical evidence of active LN, including urinary and immunological abnormalities. Twenty of pts underwent renal biopsies (66%). GFR was studied in 30 female and 3 male pts (average 39 years and duration of disease average 5 years) in two occasions over an interval of 3 to 6 months during treatment with cotricosteroids (Cs) and cytotoxic drugs (Ct). Results GFR-DTPA clearance was in range from 11 to 157 ml/min, mean 87.42 ml/min (normal >100 ml/min), in repeated measurements it was in range from 13 to 147 ml/min, mean GFR (94.33) was slightly but not significantly better. We divided pts into four groups. First group of 12 pts had values in normal range, second group of 11 pts showed an improvement in GFR from mean 64.33 to 95.50 ml/min. Mean GFR second values from third group of 6 pts (18%) were as low as in first measurements (mean 51.83), and a fall in GFR (mean 106 to 70.25 ml/min) was notified only in 4 pts (12%) as a result of deterioration of glomerular function. Conclusion During the undergoing treatment over an interval of 3 to 6 month we kept GFR in pts with LN in normal range at 12 pts (37%). Average GFR increased significantly (p < 0.05) at 11 pts (33%). The treatment LN with Cs and Ct is useful for saving renal function, and could be able to prevent the progression LN to renal failure.