ESPN 53rd Annual Meeting

ESPN 2021


 
Defining renal remission in an international cohort of children with lupus nephritis
CHIARA DE MUTIIS 1 KJELL TULLUS 2

1- PEDIATRIC DEPARTMENT, MAGGIORE HOSPITAL, BOLOGNA, ITALY
2- RENAL UNIT, GREAT ORMOND STREET HOSPITAL FOR CHILDREN NHS FT, LONDON, UK
 
Abstract:

 

Objectives:

Lupus Nephritis (LN) occurs in up to 80% of children with SLE and it affects the long term outcome. Achieving and maintaining renal remission is the goal of treatments. However definition of remission in children is not clearly defined. We compared outcomes using different published definitions of complete and partial remission.

 

Methods: 

248 children with biopsy proven LN class ≥ III (ISN/RPS), diagnosed in the last 10 years in 23 international centers were studied up to 24 months of follow-up. Children were treated according to local protocols. Seven definitions of remission from published studies and international guidelines were compared.

 

Results:

The number of children in complete and partial remission varied significantly between the different definitions.  At 24 month between 50% and 78.8% of the children were in complete remission according to the different criteria.  A relatively small percentage of children, between 2.3% to 25%, achieved partial remission during the follow-up.

Using 3 of the 7 definitions, we found no difference in terms of gender and age of children entering remission, while patients with East Asian ethnicity achieved remission more often than other ethnic groups (p < 0.05). Also children treated in high income countries showed a higher percentage of complete remission (p < 0.05).

 

Conclusion:

Rate of remission varied hugely applying the different definitions. Ethnicity and income of the country where the patients were treated influenced outcomes.

Our findings open the discussion on what to consider remission also in the perspective of new possible treatments in children.