Lupus & antiphospholipid syndrome
Histologic predictors of kidney outcomes in LN: re-evaluating the role of segmental glomerulosclerosis in the chronicity index
Authors' conclusion
Chronicity lesions in the kidney biopsy, except segmental glomerular sclerosis, are associated with time to complete/partial remission and progression to ESKD.
Study context
- Population
- Participants with biopsy-proven LN diagnosed between 2008 and 2020, follow-up ≥3 years
- Participants
- 430 participants
- Outcome
- Association of NIH activity and chronicity lesions with CR, kidney relapses and ESKD
Methodological detailstime-to-event analyses, likelihood ratios for cut-offs
- Time-to-event analyses
- Likelihood ratios for cut-offs
Main finding
As reported in the abstract
Association of histological lesions with kidney outcomes
Segmental glomerular sclerosis, HR for complete response (CR)
0.97
95% CI 0.90–1.05
Segmental glomerular sclerosis, HR for end-stage kidney disease (ESKD)
1.11
95% CI 0.99–1.25
Observational data: associations, not effects.
Further findings
Prognostic yield of chronicity index with vs without segmental glomerular sclerosis (C-statistic)
- C-statistic for CR, with vs without
- 0.66 and 0.67
- C-statistic for ESKD, with vs without
- 0.74 and 0.74
- Excluding segmental glomerular sclerosis did not modify prognostic yield
New cut-offs (positive and negative LR ≥3.0 or ≤0.33)
- Interstitial fibrosis/tubular atrophy
- 0-15%, 16-30%, >30%
- Global glomerular sclerosis
- 0-5%, 6-30%, >30%
Original publication
Histologic predictors of kidney outcomes in LN: re-evaluating the role of segmental glomerulosclerosis in the chronicity index. Rheumatology (Oxford). Published 10 April 2025. doi:10.
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