Nephritis in SLE andANCA associated vasculitis.ppt

Kaplan–Meier analysis of the probability of an absence of death (A), end-stage renal disease (ESRD) (B) or of sustained doubling of serum creatinine (SDSC) (C). Patients were randomised to a low-dose (LD) or a high-dose (HD) regimen of intravenous cyclophosphamide, followed by azathioprine. Survival curves were statistically tested with the log rank test. HR: hazard ratio (95% CI). Numbers shown along the abscissa are the number of patients at risk in each group. Analysis was by intention-to-treat. The initial CY dose was 0.5 g/m2 of body surface area and the subsequent doses were increased by 250 mg according to the white blood cell count nadir measured on day 14, with a maximum of 1500 mg per pulse. Patients assigned to the LD group received six fortnightly IVCY pulses at a fixed dose of 500 mg. In both arms, AZA (2 mg/kg/day) was started 2 weeks after the last CY injection and prescribed according to protocol at least until month 30 after inclusion. Death, sustained doubling of serum creatinine and end-stage renal disease rates did not differ between the LD and HD group (5/44 (11%) vs 2/46 (4%), 6/44 (14%) vs 5/46 (11%) and 2/44 (5%) vs 4/46 (9%), respectively) nor did mean serum creatinine, 24 h proteinuria and damage score at last follow-up. Most patients in both groups were still treated with glucocorticoids, other immunosuppressant agents and blood pressure lowering drugs. After 10 years of follow-up, the positive predictive value for a good outcome of an early drop in proteinuria in response to initial immunosuppressive therapy was confirmed. Positive predictive value for a good outcome of an early drop in proteinuria in response to initial IS therapy was confirmed Differential kinetics of 24 h proteinuria drop in patients with a good and poor long-term renal outcome. Data are shown at baseline and after 3 and 6 months of treatment for patients with good long-term renal outcome (serum creatinine at follow-up 1.4 mg/dl; n?=?65) and poor long-term renal outc