Abstract

Background: The optimal duration of maintenance therapy is controversial in proliferative
lupus nephritis. Discordance between clinical parameters of renal remission and histological
findings in immediate post induction phase as well as maintenance phase has made repeat
biopsy a compulsory tool to confirm the histological remission. But timing of repeat kidney
biopsy is debatable. Aim of this study was to find the pattern of repeat kidney biopsy findings
proliferative lupus nephritis.
Methods: Repeat biopsy (biopsy 2) performed on patients of biopsy proven (biopsy 1)
proliferative lupus nephritis (ISN/RPS 2004 class III/IV±V) between November 2011 to
September 2017 on maintenance therapy and in complete clinical remission for at least 2-
years. Clinical and histologic findings at biopsy 1 and biopsy 2 of 29 patients were compared
Results: Average time taken achieve complete remission was 9(2-24) months. Average
duration of follow up, maintenance therapy and complete clinical remission the cohort was
68±17.8, 62.5±14.2 and 58.9±17.3 months respectively. Histological remission was observed
in 93.1%. Other than duration of complete remission on maintenance therapy none of the
variables failed to predict the histological remission.
Conclusion: Majority of patients were in complete histological remission in repeat kidney
biopsy proliferative lupus nephritis following sustained clinical remission on maintenance
immunosuppressive therapy