Extended reports
Renal haemodynamic characteristics in patients with lupus
nephritis
Department of Medicine (II), Niigata University School
of Medicine, Asahimachi-Dori 1-757, Niigata 951, Japan
Correspondence to: Dr Nakano.
Accepted for publication 29 January 1998
OBJECTIVE
To clarify the characteristics of renal
haemodynamics in patients with lupus nephritis (LN).
METHODSThe glomerular filtration rate (GFR) and
renal plasma flow (RPF) of 37 patients with active LN were studied
longitudinally over an interval of 8 to 144 weeks during treatment with
corticosteroids or cytotoxic drugs, or both. All patients had clinical
renal disorders and underwent renal biopsies.
RESULTSAnalysis of renal biopsy specimens
showed that 31 patients had class IV LN. Class II, III, and V LN were
present in two patients each. The average GFR increased significantly
from 65.4 (SD 33.0) in the pretreatment stage to 86.6 (31.6) ml/min in
the post-treatment stage, accompanied by an improvement in urinary
or immunological abnormalities, or both. On the other hand, RPF
decreased significantly from 625.2 (243.0) to 519.8 (179.0) ml/min.
Therefore, the filtration fraction (FF) increased significantly from
10.7 (4.3)% to 16.8 (3.7)%. Low FF was recognised predominantly in
patients with class IV LN, but was also observed in patients with
other classes. The FF returned towards normal irrespective of the
degree of GFR recovery. No significant changes were observed in the
levels of blood pressure.
CONCLUSIONA reduction in GFR out of proportion to
the reduction in RPF as demonstrated by the low FF values was related
to the severity of LN or disease activity, or both. Therefore, relative
evaluation of GFR and RPF, namely the determination of FF, may be a
useful clinical parameter to determine the status of LN.
© 1998 by Annals of the Rheumatic Diseases
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