Lupus Nephritis

Lupus nephritis with renal thrombotic microangiopathy doesn’t increase risk of ESKD

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The risk for end-stage kidney disease (ESKD) is not significantly increased in patients with lupus nephritis (LN) with renal thrombotic microangiopathy (TMA), according to a study, which also found these patients likely respond to treatment comparably to those without TMA.

In this single-center, retrospective study, the outcomes of 17 cases of LN with concomitant TMA on kidney biopsy and 28 control cases of individuals with LN without TMA matched to cases based on demographic and clinical variables were analyzed.

Baseline levels of creatinine, proteinuria, and chronicity on biopsy were greater in patients with TMA compared with controls.

The rates of remission at 6-months were 53.9% and 46.4% for TMA cases and controls, respectively; at 12-months rates were 53.9% and 50.0%, respectively.

Univariate analysis found that there was a greater risk for EKSD in TMA cases but not when adjusted for serum creatinine and proteinuria.

There was no significant difference in the risk of death between the groups.

Massicotte-Azarniouch D, Kotzen E, Todd S, et al K. Kidney thrombotic microangiopathy in lupus nephritis: Impact on treatment and prognosis. Lupus. 2022;9612033221106301. doi: 10.1177/09612033221106301. Epub ahead of print. PMID: 35650019.