Objectives: The objective of this paper is to describe renal outcomes in a group of Egyptian patients with lupus nephritis and to identify variable prognostic factors. Patients and methods: The records of 135 patients (129 females, six males) with biopsy-proven lupus nephritis seen between 1999 and 2011 at Kasr Al-Aini Hospital, Cairo University, were reviewed and included in a retrospective analysis. Biopsies were classified according to the WHO classification. Renal outcomes were defined according to the Renal Subcommittee of Renal Insufficiency of the American College of Rheumatology. Results: The mean follow-up period was 55.64-25.68 (range 4-156) months. Thirty-nine patients (29.9%) developed an adverse final outcome. This composite outcome, defined as persistent elevation of serum creatinine ≥1.2 mg/dl, chronic renal insufficiency, end-stage renal disease or death, was seen in 12 (8.9%), seven (5.2%), three (2.2%) and 17 (12.6%) patients, respectively. The overall patient survival was 93.5% and 87.5% at five and 10 years, respectively. Factors associated with an adverse outcome included male gender (p=0.037), hypertension at nephritis onset (p=0.001), serum creatinine ≥1.2 mg/dl (p<0.001), urinary casts (p=0.006), anticardiolipin antibodies (p=0.03), class IV nephritis (p<0.001), hyaline thrombosis (0.003), glomerular sclerosis (p=0.002), tubular atrophy(p<0.001), interstitial fibrosis (p<0.001) and a higher chronicity index (p=0.006). Time-dependent factors associated with an adverse outcome included failure to achieve remission within the first year, uncontrolled hypertension, persistently low C3 and development of flares (p=0.003, <0.001, = 0.004, = 0.003, respectively). Conclusion: The association of several adverse prognostic factors with the development of poor renal outcome has been confirmed in this study.
