Lupus & antiphospholipid syndrome
Beyond glomeruli in lupus nephritis: Impact of tubulointerstitial inflammation and interstitial fibrosis/tubular atrophy on renal function decline – A systematic review and meta-analysis
Authors' conclusion
This meta-analysis found that both interstitial fibrosis/tubular atrophy (IFTA) and tubulointerstitial inflammation (TII) are significantly associated with renal function decline in lupus nephritis, suggesting a worse prognosis.
Study context
- Population
- Adult patients with LN
- Participants
- 3,607 patients21 retrospective studies
- Comparison
- Presence vs absence of tubulointerstitial inflammation (TII) or interstitial fibrosis/tubular atrophy (IFTA) on LN biopsy
- Outcome
- Renal function decline
Methodological detailsrandom-effects models, prespecified subgroup analyses by follow-up duration, leave-one-out sensitivity analyses, meta-regression
- Random-effects models
- Prespecified subgroup analyses by follow-up duration
- Leave-one-out sensitivity analyses
- Meta-regression
Pooled result
As reported in the abstract
Relative risk (95% CI)
TII
2.22(1.75–2.82)
IFTA
3.44(2.70–4.38)
TIIvs IFTA
0.78(0.59–1.03)
Further pooled results
Renal decline by follow-up duration (subgroup)
- TII association stronger in studies with longer follow-up (>5 years); IFTA consistently elevated risk across follow-up strata
Publication bias
- Egger's test: no evidence of publication bias
- P = 0.9074
Meta-regression by glomerular pattern
- TII association varied with distribution of proliferative glomerular classes; IFTA association not significantly modified
Original publication
Beyond glomeruli in lupus nephritis: Impact of tubulointerstitial inflammation and interstitial fibrosis/tubular atrophy on renal function decline – A systematic review and meta-analysis. Lupus. Published 20 March 2026. doi:10.
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