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Updated: Jul 16, 2026
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Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
Published on: June 8, 2022
Lupus nephritis: prognostic factors in children
D K McCurdy1, T J Lehman, B Bernstein
1Division of Rheumatology, Childrens Hospital of Los Angeles, CA.
Pediatrics
|February 1, 1992
Summary
Identifying risk factors for renal failure in pediatric lupus nephritis is crucial. Persistent hypertension, anemia, urinalysis abnormalities, and high creatinine levels predict progression, while certain biopsy findings also indicate poor outcomes.
Area of Science:
- Pediatric Nephrology
- Rheumatology
- Pathology
Background:
- Systemic lupus erythematosus (SLE) can lead to lupus nephritis, a severe kidney complication.
- Identifying children at risk for end-stage renal disease (ESRD) is vital for timely intervention.
Purpose of the Study:
- To identify clinical and pathological predictors of renal failure progression in children with lupus nephritis.
- To assess outcomes for pediatric patients with lupus nephritis requiring renal replacement therapy.
Main Methods:
- Retrospective review of 90 children with SLE over 13 years.
- Analysis of clinical data (hypertension, anemia, creatinine, urinalysis, creatinine clearance, urine protein) and renal biopsy findings (WHO classification, activity/chronicity indices).
Main Results:
- 16 of 71 children (22%) progressed to chronic renal failure.
- Significant predictors included persistent hypertension (>4 months), anemia, urinalysis abnormalities, elevated serum creatinine, and diffuse proliferative glomerulonephritis on biopsy.
- Both active (necrotic, inflammatory) and chronic (sclerotic) biopsy lesions correlated with progression.
- Outcomes for those progressing to renal failure were poor, with high mortality on dialysis.
Conclusions:
- Clinical and pathological markers can identify children with lupus nephritis at high risk for renal failure.
- Pediatric lupus nephritis patients progressing to ESRD have a poor prognosis, particularly those requiring dialysis.
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