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Lupus Nephritis

Predictors of lupus nephritis outcomes remain stagnant

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There are no new biomarkers that identify the renal prognosis of patients with lupus nephritis (LN), instead, classic clinical, renal, and histological markers continue to be used, according to a study in Lupus.

A lack of clear definition of renal outcomes may be complicating risk stratification in patients with LN, according to the authors.

A total of 25 studies (15 retrospective, 9 prospective, and 1 a trial extension study) on all targeted outcomes of LN, including kidney failure, response to treatment, cardiovascular events, and mortality, were included.

Predictive factors of renal response:
-Serum creatinine and glomerular filtration rate C3 levels
-Titer of anti-C1q
-Anti-dsDNA antibodies

Risk factors for the development of chronic kidney disease:
-Class type IV or V
-Tubulointerstitial or vascular lesions
-Chronicity index

Factor associated with persistence of activity:
-Anti-dsDNA, anticardiolipin
-Anti C1q antibodies
-Complement values.

The factors associated with cardiovascular events/mortality:
-Amount of proteinuria
-Histological findings.

Rodríguez-Almaraz E, Gutiérrez-Solís E, Rabadán E, et al. Something new about prognostic factors for lupus nephritis? A systematic review. Lupus. 2021;doi: 10.1177/09612033211061475. Epub ahead of print. PMID: 34907831.