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Background. Few data are available about the very long-term outcome of patients with proliferative lupus nephritis.

Methods. Ninety-three Italian patients with biopsy-proven proliferative lupus nephritis (15 with class III, 9 with class III + V, 64 with class IV and 5 with class IV + V) followed for a median follow-up of 15 years in a single renal unit were considered for this observational study. Patients were treated with an induction treatment consisting of high doses of corticosteroids plus immunosuppressive agents in the more severe cases. This treatment was repeated in the event of a renal flare. Then corticosteroids and immunosuppressive agents were reduced to the minimal effective dose for maintenance.

Results. Renal survival including death was 97% at 10 years and 82% at 20 years. At the last follow-up visit, 59 patients were in complete renal remission, 18 were in partial renal …