Lupus & antiphospholipid syndrome
Does the time to the onset of lupus nephritis impact renal disease presentation and outcomes?
Authors' conclusion
Intermediate LN, occurring between the first and fifth year after SLE onset, is associated with the worst renal outcomes.
Study context
- Population
- Inception cohort patients with Systemic Lupus Erythematosus (SLE) who developed lupus nephritis (LN) during follow-up; median age 34.3 yearsinception cohort
- Participants
- 246 patients
- Exposure
- Intermediate and delayed vs early time to LN onset after SLE onset
- Early LNn = 160reference
- Intermediate LNn = 42
- Delayed LNn = 44
- Outcome
- Complete proteinuria recovery (CPR) at 1 year; adverse composite outcome (ESKD, sustained ≥40 % decline in eGFR, or death); subsequent LN flares
Methodological detailsCox proportional hazard models
- Cox proportional hazard models
Main finding
As reported in the abstract
- Delayed LN less likely to achieve complete proteinuria recovery (CPR) at 1 year
- Early LN had the lowest risk of the adverse composite outcome
- Intermediate vs early LN: increased risk of the adverse composite outcome (Cox models)
- Intermediate vs early LN: trend towards higher association with subsequent LN flares
Observational data: associations, not effects.
Further findings
Baseline characteristics
- Median [IQR] age, years
- 34.3 [26.2, 44.7]
- Median disease duration, years
- 0.6 [0.2, 2.6]
- Delayed LN patients older, higher SDI, used GC and immunosuppressives less frequently
Original publication
Does the time to the onset of lupus nephritis impact renal disease presentation and outcomes? Semin Arthritis Rheum. Published 13 April 2025. doi:10.
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