Lupus nephritis in black and Hispanic children

Area of Science:

• Pediatric Nephrology
• Rheumatology
• Immunology

Background:

• Lupus nephritis is a severe complication of Systemic Lupus Erythematosus (SLE) affecting children.
• Long-term outcomes and prognostic factors in pediatric lupus nephritis require further investigation, particularly in diverse populations.

Purpose of the Study:

• To evaluate the long-term outcomes of lupus nephritis in a cohort of Black and Hispanic children.
• To identify potential risk factors, such as age at onset, influencing disease progression and mortality.

Main Methods:

• Retrospective analysis of 23 Black and Hispanic children diagnosed with lupus nephritis.
• Long-term follow-up ranging from 2 to 16.5 years (mean 5.4 years).
• Comparison of outcomes between children with disease onset before and after 10 years of age.

Main Results:

• Mean age at onset was 10.1 years, younger than reported in other series.
• A statistically significant higher incidence of renal death was observed in younger children (onset < 10 years).
• Overall, 50% of patients experienced severe renal complications, including death (25%) or end-stage renal disease (25%).

Conclusions:

• Pediatric lupus nephritis in this cohort exhibited higher mortality and morbidity compared to recent reports.
• Younger age at onset and potentially race act synergistically, contributing to poorer long-term renal outcomes.
• Early-onset lupus nephritis in minority children warrants aggressive management and closer monitoring.