SAT0215 Clinical presentation, treatment and outcome of membranous nephropathy in SLE: A comparison with proliferative lupus glomerulonephritis in 141 patients

Objectives To study the presentation and outcome of membranous nephropathy in SLE in comparison with proliferative lupus glomerulonephritis. Methods Patients with biopsy firmed active lupus nephritis who were recruited in a randomized trial of mycophenolate mofetil (MMF) and tacrolimus (Tac) from 2005 to 2011 were studied. Participants were divided into 3 groups according to renal histology: group I (pure membranous lupus Gn:RPS/ISN class V); group 2 (mixed membranous/proliferative Gn: V+III or IVS/IVG) and group 3 (proliferative lupus Gn:IVS/IVG). The clinical presentation, treatment response, outcome were compared. Results 141 patients were studied (92%women; age 35.2±12.8 years, SLE duration 49.3±62 months). There were 25 (18%), 31 (22%) and 85 (60%) patients in group 1, 2 and 3, respectively. At presentation, group 1/2 patients had significantly higher hemoglobin (11.3±1.8vs9.9±1.7g/dL), creatinine clearance (CrCl) (90.0±31vs69.7±27ml/min), complement C3 level (0.62±0.27vs0.42±0.16g/L) but lower serum Cr (70.8±25vs91.5±33umol/L) and anti-dsDNA titer (166±116vs234±89IU/ml) than group 3 patients (p Conclusions The presence of histological membranous component in lupus nephritis is associated more proteinuria, better renal function but less active lupus serology or extra-renal activity at presentation. One-third of patients have either normal complements or anti-dsDNA, and complete response to induction therapy is less likely. Renal function decline in membranous lupus nephropathy is no different from proliferative lupus nephritis at 5 years, but thrombotic complications are more frequent. Disclosure of Interest None Declared