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  3. Risk Of Chronic Kidney Disease In 260 Patients With Lupus Nephritis: Analysis Of A Nationwide Multicentre Cohort With Up To 35 Years Of Follow-up.
  1. Home
  3. Risk Of Chronic Kidney Disease In 260 Patients With Lupus Nephritis: Analysis Of A Nationwide Multicentre Cohort With Up To 35 Years Of Follow-up.

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Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
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Risk of chronic kidney disease in 260 patients with lupus nephritis: analysis of a nationwide multicentre cohort with

Filipa Farinha1, Sofia Barreira2, Maura Couto3

  • 1Centre for Rheumatology, University College of London, London, United Kingdom.

Rheumatology (Oxford, England)
|April 22, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

This study compared lupus nephritis (LN) types, finding that membranous LN (MLN) patients had better initial kidney function. An estimated glomerular filtration rate (eGFR) below 75 mL/min/1.73 m² after one year strongly predicted chronic kidney disease (CKD) progression in LN.

Keywords:
chronic kidney diseasemembranous lupus nephritisproliferative lupus nephritissurvival analysissystemic lupus erythematosus

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Area of Science:

  • Nephrology
  • Rheumatology
  • Immunology

Background:

  • Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus (SLE).
  • Histological classification of LN, particularly proliferative (PLN) and membranous (MLN) types, influences prognosis and treatment strategies.
  • Understanding the distinct clinical presentations and long-term outcomes of PLN versus MLN is crucial for patient management.

Purpose of the Study:

  • To compare clinical and laboratory features of proliferative (PLN) and membranous (MLN) lupus nephritis (LN).
  • To evaluate long-term outcomes, including progression to chronic kidney disease (CKD), for PLN and MLN patients.
  • To identify predictors of CKD development in LN.

Main Methods:

  • Multicenter observational study with retrospective analysis of a prospective cohort.
  • Inclusion of patients with biopsy-proven PLN, MLN, or mixed LN.
  • Cox regression survival analysis to determine CKD predictors.

    • Main Results:

    • MLN patients exhibited lower serum creatinine and near-normal complement levels compared to PLN patients.
    • Proteinuria levels did not differ significantly between PLN and MLN groups.
    • An estimated glomerular filtration rate (eGFR) ≤75 mL/min/1.73 m² at one year post-treatment was the strongest predictor of CKD progression (HR 23).

    Conclusions:

    • Histological class of LN was not predicted by proteinuria levels in this cohort.
    • An eGFR cutoff of 75 mL/min/1.73 m² after one year of treatment is a strong predictor of progression to CKD in lupus nephritis.