Actually, the degree of interstitial injury might become a better renal predictor than glomerular damages in chronic progressive glomerular diseases. Early interstitial change is included infiltration of inflammatory cells, but the finding can be reversible
by therapy. Thus, we evaluated the interstitial fibrosis as one of the indicators of renal prognosis in patients with LN. Methods: Forty-three patients who had been diagnosed as systemic lupus erythematosus Proteasome inhibitor (SLE) and performed renal biopsy in our department from 1987 to 2012 were enrolled. All patients were reviewed by means of ISN/RPS classification and were semiquantitatively evaluated interstitial fibrosis in the same way as described previously (no interstitial fibrosis:
0%, mild interstitial fibrosis: 0–25%, moderate interstitial fibrosis: 25–50%, severe interstitial fibrosis: >50%). Their blood and urinary examinations were evaluated at the time of renal biopsy and at the last follow up period. Results: According to ISN/RPS classification, renal function (SUN, sCre and eGFR) both at the time of biopsy and at the last Proteases inhibitor follow up period didn’t have statistical difference. When all patients were divided into semiquantitative interstitial fibrosis grade, there was no significant difference concerning about renal function at the time of biopsy. Renal symptoms of severe fibrosis grade presented significantly worse renal prognosis than other interstitial fibrosis grades
(no, mild and moderate interstitial fibrosis grade, respectively) at the last follow up period in the levels of SUN (p < 0.01), sCre (p < 0.05) and eGFR (p < 0.01, p < 0.05, p < 0.01, respectively). The serum SLE activity (C3, C4 and anti-DNA antibody) significantly ameliorated after appropriate treatments in spite of ISN/RPS classification or the interstitial fibrosis grade (data not shown). Conclusion: We should recognize the severe interstitial fibrosis as a eltoprazine predictor for worsening renal function and an independent factor from glomerular lesions or the serum SLE activity. ENDO NOBUHIDE, TSUBOI NAOTAKE, FURUHASHI KAZUHIRO, MATSUO SEIICHI, MARUYAMA SHOICHI Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan Introduction: In addition to the effector roles of classically activated macrophages for tissue injury, recent studies have shown that alternatively activated (M2) macrophages are involved in resolution of inflammation in animal models of kidney disease. But, clinical relevance of M2 macrophage in human disease is largely unknown.