2017 Volume 63 Issue 5 Pages 362-369
Objective: The International Society of Nephrology-Renal Pathology Society (ISN/RPS) 2003 classification of lupus nephritis (LN) was designed to provide beneficial pathologic information relevant to the renal outcome. We conducted a retrospective observational study to investigate the baseline characteristics and renal response to treatment for patients with LN, comparing the World Health Organization (WHO) and ISN/RPS classification systems.
Materials: A total of 39 Japanese patients (2 men; 37 women) with LN who underwent percutaneous needle renal biopsy between 1998 and 2012 were evaluated.
Methods: Renal biopsy samples were classified using the 1995 WHO and 2003 ISN/RPS criteria.
Results: Among WHO class IV patients, a higher number of patients reclassified into ISN/RPS class III achieved complete response to treatment compared to those reclassified into class IV at 6 months follow-up. Twenty patients in WHO class IVc were reclassified into ISN/RPS classes III, III+V, IV-S, IV-S+V, IV-G and IV-G+V. No patients developed end-stage renal failure requiring renal replacement therapy.
Conclusions: The results suggest that the ISN/RPS classification system is more advantageous in predicting renal outcome and guiding treatment, especially for those previously classified with WHO class IVc LN.
