Evaluation of clinical and histological response and biomarkers after induction treatment for Lupus nephritis

Abstract

Systemic lupus erythematosus (SLE) is a multisystemic, chronic inflammatory autoimmune disease of unknown etiology. Lupus nephritis (LN) occurs in 40 to 75 percent of patients and it is associated with a significant morbimortality. LN presents distinct severity, with frequent flares when not adequately treated. Clinical and laboratory test cannot predict histological findings in the majority of LN cases, and renal biopsy should be done whenever possible. Objective: the principal objective is to evaluate the histopathological renal response in the rebiopsy after induction therapy and to correlate with a clinical renal response and biomarkers. The secondary objective are: to describe activity and chronicity index, the alterations on the glomerular component, characterize the findings on tubulo, interstitial and vascular components, as well correlate with laboratory parameters and renal biomarkers. Material and Methods: open multicenter prospective study at University hospitals in São Paulo, João Pessoa, Belo Horizonte, and Recife, with 60 consecutive LN patients. Two biopsies will be performed. The first for diagnosis of LN and the second after induction therapy, and renal biomarkers will be measured before and at the end of this therapy. Expected Results: This study may show the need for rebiopsy for the adequate treatment of LN, as well, show if the biomarkers could reduce the necessity of renal biopsy. (AU)