1 ± 33.2 ml/min/1.72 m2 and 3.9 ± 4.0 g/gCr, respectively. The relative frequency of each class was as follows; class II 13%, class III 15%, class IV 43%, class V 15% and class III/IV+V (mixed type) 20%. During the median follow-up of 100 months (range 3–397), 13 patients reached the renal endpoints; 1 in class II, 1 in class III, 5 in class IV, 2 in class V and 5 in class III/IV+V. Multivariable analysis with Cox proportional hazards model indicated that eGFR at the time of biopsy and the FK506 chemical structure mixed type are the independent risk factors for poor renal prognosis, with hazard ratios of 0.97 (95%CI 0.94–0.99, P = 0.003) and 6.71 (95%CI 1.88–23.93, P = 0.003), respectively. Age, sex, blood pressure, serum albumin, CH50, hemoglobin,

ratio of urinary protein/creatinine and anti-DNA antibodies were not significant factors. Kaplan-Meier analysis

also showed that patients with mixed type LN had poor renal outcome compared to patients with proliferative lesions alone (pure class III and IV, P = 0.003). Conclusion: This study demonstrated that combinations of membranous and proliferative LN is associated with poor renal prognosis. ALSUWAIDA ABDULKAREEM, HUSSAIN SUFIA, AL GHONAIM MOHAMMED, KFOURY HALA King Saud University Background: Although necrotic lesions in lupus nephritis are common in proliferative lupus nephritis (LN), little is known about the impact of these lesions on long-term outcomes. This study was undertaken to investigate the response to therapy and renal outcomes of doubling serum creatinine in patients ISN/RPS class III and IV LN

and necrotic lesions. Methods: 52 patients with CP-690550 purchase ISN/PRS class III or IV LN were enrolled in this retrospective study with mean follow up of Nintedanib (BIBF 1120) 7.4 years. Clinicopathological features, treatment responses, and outcomes were compared among those with and without necrotic lesions. Necrosis was defined as fragmentation of nuclei or disruption of the glomerular basement membrane with fibrin-rich material. Results: The prevalence of necrotizing lesions was seen in 20% of those with class III versus 51.8% of class IV (P = 0.02). The initial median serum creatinine was 75 umol/l (Mean 118 ± 122 umol/l) in those with necrotizing lesions and 79 umol/l (Mean 135 umol/l ± 106) in those with no necrosis (P = 0.6). Proteinuria was more severe among those with necrosis (The median proteinuria was 3.03 gram per day among those with no necrosis and 0.76 gm per day among those with no necrosis (P = 0.005). The rate of complete remission was seen in 48.5% and 42.1% among those with and without necrosis, respectively. The proportion of doubling of serum creatinine was seen in 31.6% in those with necrosis and 18.2% with no necrosis (P = 0.27). Conclusions: The probability of getting remission or doubling of serum creatinine were similar among those with and without necrotizing lesions in ISP/PRS class III and IV LN. Early and adequate treatment in sever LN protect the kidneys from developing chronic renal impairment.