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Lupus Nephritis

Model predicts poor prognosis in lupus nephritis

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Patients with lupus nephritis (LN) that have low-level proteinuria and hypoalbuminemia have an increased hazard of progression to poor outcomes, according to a study.

In this retrospective study, 2163 patients with systemic lupus erythematosus (SLE) who completed routine follow-up were identified and 376 cases of LN were enrolled. There was a mean follow-up time of 55 months.

According to the researchers, “poor prognosis was defined as all-cause mortality or a persistent decrease of eGFR greater than half the baseline level or progression to end-stage renal disease (ESRD).”

Overall, 9.8% (n = 37 patients) reached the composite endpoint. Classification of LN was associated with proteinuria levels, with patients with class IV or class IV + V experiencing the most severe proteinuria.

According to the multivariate Cox regression model, sex, ISN/RPS class, tubular atrophy/interstitial fibrosis, serum albumin, tertiles of proteinuria, and their interaction were independently associated with a poor prognosis. External validation found that the model used was efficient and robust for distinguishing poor prognosis.

Zhang J, Song H, Li D, et al. Role of clinicopathological features for the early prediction of prognosis in lupus nephritis. Immunol Res. 2021;doi: 10.1007/s12026-021-09201-8. Epub ahead of print. PMID: 33954909.