Lupus nephritis in childhood: A multicentre study

Lupus nephritis (LN) in childhood presents some special features: more males are affected than in adult onset cases and prognosis is reputed to be worse in children. It is an uncommon disorder in childhood, making it difficult for a Pediatric Nephrology Unit to have a substantial number of patients to be analysed. Consequently we performed a multicentre retrospective study collecting data from eight Spanish Hospitals. The total number of patients was 73, 57 females and 16 males (Female/Male ratio 3.5/1). Age on onset of the disease was 10.8 +/- 2.4 years, age at the end of the follow-up was 17.4 +/- 4.5. The mean follow-up period was 6.5 +/- 4.5 years. Initial renal abnormalities were: hematuria (82%), proteinuria (75%), nephrotic syndrome (49%), hypertension (28%) and renal insufficiency (28%). Eighty-hive renal biopsies were performed in 64 patients. Class IV nephritis was the most frequent diagnosis. All patients were treated with steroids and 52 children received steroids and immunossuppresors. At the end of the follow-up period six patients had died and five had developed and stage renal failure. Renal survival was 86% at ten years and patient survival was 90% at ten years.