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  11. Treating Lupus Nephritis Patients To Lupus Low Disease Activity Reduces Renal Relapse And Preserves Long-term Kidney Function

Treating lupus nephritis patients to lupus low disease activity reduces renal relapse and preserves long-term kidney function

Chak Kwan Cheung1, Desmond Yh Yap1, K L Lee2

  • 1Queen Mary Hospital, The University of Hong Kong, Hong Kong.

Arthritis Care & Research
|July 21, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Achieving Lupus Low Disease Activity State (LLDAS) in lupus nephritis (LN) is attainable and linked to reduced relapse risk. Early LLDAS attainment also predicts better long-term kidney function preservation in LN patients.

Area of Science:

  • Nephrology
  • Rheumatology
  • Immunology

Background:

  • Lupus low disease activity state (LLDAS) is a validated treatment target in systemic lupus erythematosus (SLE).
  • Limited research exists on LLDAS in lupus nephritis (LN), a severe SLE manifestation affecting kidneys.

Purpose of the Study:

  • Investigate the frequency and predictors of LLDAS attainment in LN patients.
  • Evaluate the benefit of LLDAS on LN relapse and renal function preservation.

Main Methods:

  • Retrospective analysis of 245 LN patients across two hospital cohorts (2010-2020).
  • Assessment of complete renal response (CRR), partial renal response (PRR), LLDAS, and DORIS remission at 12 months.
  • Regression analysis and ROC curves used to identify predictors and evaluate outcomes.

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Main Results:

  • 49% of LN patients achieved LLDAS at 12 months, comparable to CRR/PRR rates.
  • Achieving both CRR/PRR and LLDAS significantly improved relapse-free survival (p<0.001).
  • LLDAS attainment independently reduced LN relapse risk (HR=0.38, p=0.029) and predicted renal function preservation (AUC-ROC=0.71).

Conclusions:

  • LLDAS is an achievable and valuable treatment target in lupus nephritis.
  • Attaining both LLDAS and renal response targets offers synergistic benefits in reducing relapse risk.
  • Early LLDAS attainment is crucial for preserving long-term renal function in LN patients.