Volume 61, Issue 4, Pages 1502-1509 (April 2002) Renal flares in 91 SLE patients with diffuse proliferative glomerulonephritis  Marta Mosca, Walter Bencivelli, Rossella Neri, Antonio Pasquariello, Valentina Batini, Rodolfo Puccini, Antonio Tavoni, Stefano Bombardieri  Kidney International  Volume 61, Issue 4, Pages 1502-1509 (April 2002) DOI: 10.1046/j.1523-1755.2002.00280.x Copyright © 2002 International Society of Nephrology Terms and Conditions

Figure 1 Risk of renal flare according to age. Survival analysis (absence of renal flares) of the period between the initiation of therapy and the time of occurrence of the first flare demonstrated the prognostic value of age at the time of biopsy [(dashed line) <30 years vs. (solid line) ≥30 years]; a younger age was associated with an increased risk (P < 0.01, log rank test). At 5 years the probability of not flaring was 65% (21 patients at risk of flaring) versus 26% (12 patients at risk of flaring) for patients with age ≥30 versus age <30 years, respectively; at 10 years the probability of not flaring was of 58% versus 23% in the two groups. Kidney International 2002 61, 1502-1509DOI: (10.1046/j.1523-1755.2002.00280.x) Copyright © 2002 International Society of Nephrology Terms and Conditions

Figure 2 Risk of renal flares according to the activity index (AI). Survival analysis (absence of renal flares) based on AI values ≥10 (dotted line) or <10 (solid line) demonstrated the prognostic significance of AI, as an AI ≥10 was associated with a higher risk of flares (P < 0.005, log rank test). At 5 years the probability of not flaring was of 53% (22 patients at risk of flaring) versus 27% (6 patients at risk for flaring) for patients with low and high AI, respectively. At 10 years the probability of not flaring was of 50% versus 21%, respectively. Kidney International 2002 61, 1502-1509DOI: (10.1046/j.1523-1755.2002.00280.x) Copyright © 2002 International Society of Nephrology Terms and Conditions

Figure 3 Risk of renal flares according to the initial treatment with (heavy solid line) steroids alone versus (thin solid line) steroids plus immunosuppressive drugs. In the survival analysis (absence of renal flares), the therapy did not seem to alter the timing of the flares (P = NS), although the curve suggests that there is a reduced long-term risk in patients treated with immunosuppressive drugs. Kidney International 2002 61, 1502-1509DOI: (10.1046/j.1523-1755.2002.00280.x) Copyright © 2002 International Society of Nephrology Terms and Conditions

Figure 4 Risk of poor renal outcome of 91 systemic lupus erythematosus (SLE) patients. At 5 years the probability of doubling serum creatinine is 21% (50 patients at risk); at 10 years the probability of doubling of serum creatinine is 38% (21 patients at risk). Kidney International 2002 61, 1502-1509DOI: (10.1046/j.1523-1755.2002.00280.x) Copyright © 2002 International Society of Nephrology Terms and Conditions

Figure 5 Risk of doubling serum creatinine based on serum creatinine values at the time of renal biopsy, for serum creatinine>1.2 (dotted line, abnormal creatinine) or ≤1.2 (solid line; normal creatinine). The survival time is defined as the interval from the moment of the biopsy to the doubling of serum creatinine (P < 0.01; log rank test). Survival analysis (poor renal outcome) demonstrated that at 5 years the probability of not doubling serum creatinine was 73% (13 patients at risk of poor renal outcome) versus 81% (37 patients at risk of poor renal outcome) for patients with elevated versus normal serum creatinine. At 10 years the probability of not doubling serum creatinine was 36% versus 72%, respectively. Kidney International 2002 61, 1502-1509DOI: (10.1046/j.1523-1755.2002.00280.x) Copyright © 2002 International Society of Nephrology Terms and Conditions

Figure 6 Risk of doubling serum creatinine according to chronicity index on renal biopsy. Survival analysis for patients with chronicity index (CI) ≥3 (dotted line) or <3 (solid line) demonstrated the prognostic role of CI. A CI above 3 was correlated with doubling of serum creatinine (P < 0.001; log rank test). At 5 years the probability of not doubling serum creatinine was 38% (4 patients at risk of poor renal outcome) versus 83% (37 patients at risk of poor renal outcome) for patients with high and low CI, respectively. At 10 years the probability of not doubling serum creatinine was 14% versus 69%, respectively. Kidney International 2002 61, 1502-1509DOI: (10.1046/j.1523-1755.2002.00280.x) Copyright © 2002 International Society of Nephrology Terms and Conditions

Figure 7 Survival analysis (poor renal outcome) for patients with a follow-up of at least 5 years who had (dashed line) or did not have (solid line) renal flares in the first 5 years after renal biopsy. The occurrence of renal flares was correlated with a poor renal outcome (P < 0.01; log rank test). At 10 years after the renal biopsy, the probability of not doubling serum creatinine was 50% (7 patients at risk of poor outcome) versus 84% (14 patients at risk of poor outcome) in patients who had renal flares versus patients who did not have renal flares. At 15 years the probability of not doubling serum creatinine was 33% versus 84%, respectively. Kidney International 2002 61, 1502-1509DOI: (10.1046/j.1523-1755.2002.00280.x) Copyright © 2002 International Society of Nephrology Terms and Conditions