Association of Clinical Response to Therapy with Long-Term Renal Outcomes in Lupus Nephritis: A Systematic Review and Meta-Analysis

The aim of the present thesis was to study the effect of clinical response in lupus nephritis on long-term disease outcomes, namely chronic kidney disease, end-stage kidney disease, and mortality. We examined key topics related to lupus nephritis, including its epidemiology and pathogenesis, clinical manifestations, and histopathology. We also compiled the current definitions of clinical response and discussed the prognosis of lupus nephritis with regard to the long-term outcomes defined in our study, and also provided a brief overview of the treatment of the disease. Finally, we conducted a meta-analysis on the impact of clinical response on mortality, chronic kidney disease, and end-stage kidney disease in patients with lupus nephritis. The results of our study showed that achieving a clinical response (complete or partial) protects against the development of chronic kidney disease or end-stage kidney disease. Moreover, complete response is more beneficial than partial response in terms of progression to end-stage kidney disease in patients with lupus nephritis. Lastly, with respect to mortality, clinical response did not have a statistically significant effect.