Lupus & antiphospholipid syndrome
Clinical and immunological biomarkers can identify proliferative changes and predict renal flares in lupus nephritis
Authors' conclusion
Immunological tests can differentiate proliferative from non-proliferative LN, but anti-C1qAb and urinary erythrocytes had the best predictive power.
Study context
- Population
- Patients with lupus nephritis (LN) undergoing kidney biopsy53 evaluated for flares
- Participants
- 61 patients
- Exposure
- Proliferative vs non-proliferative LN; predictors of renal flares
- Proliferative LNn = 47
- Non-proliferative LNn = 14reference
- Outcome
- Value of immunological tests (C3, C4, anti-DNA, anti-C1q antibodies (Ab)) in predicting histological classes and flares of LN
Methodological detailslinear and multiple regression analyses, univariable and multivariable Cox analyses
- Linear and multiple regression analyses
- Univariable and multivariable Cox analyses
Main finding
As reported in the abstract
Immunological tests, proliferative vs non-proliferative LN · day of kidney biopsy
Multiple regression: urinary erythrocytes, OR
3.2292
CI 1.2585–8.2858p = 0.0148
Multiple regression: anti-C1qAb, OR
1.0288
CI 1.0016–1.0568p = 0.0380
Observational data: associations, not effects.
Further findings
Renal flare · followed 60.69 (37.20-78.704) months
- Renal flare, n (%)
- 10 (18.86%)
- Time to flare from therapy initiation, months (24.84-39.38, range:16.3-55.8)
- 28.19
- 53 patients evaluated
Univariable predictors of flare at baseline and 6 months
- anti-C1qAb (p = 0.0340, p = 0.0005)
- No-use HCQ (p = 0.0313, p = 0.0276)
Univariable predictors of flare at 12 months
- anti-C1qAb (p = 0.0047)
- Non-use HCQ (p = 0.0252)
- anti-C1qAb ≥ 40UA (p = 0.0047)
- 24/h proteinuria (p = 0.0185)
- Proteinuria ≥ 0.5 g/day (p = 0.0216)
Multivariable independent predictors of renal flares
- anti-C1q > 40UA, OR
- 9.0721 (CI 0.9146-42.9882; p = 0.0057)
- Non-use of HCQ, OR
- 0.1742 (CI 0.0445-0.6823; p = 0.0126)
Original publication
Clinical and immunological biomarkers can identify proliferative changes and predict renal flares in lupus nephritis. Arthritis Res Ther. Published 31 March 2025. doi:10.
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