How have the clinical, laboratory, treatment features and outcomes in children with lupus nephritis progressed over the last 30 years?
Authors' conclusion
Over the years, there have been significant improvements in the diagnosis and management of children with SLE resulting in an earlier diagnosis, lower disease activity at onset, and improved outcomes.
Study context
- Population
- Paediatric-onset lupus nephritis (LN) patients
- Participants
- 103 patients
- Exposure
- LN diagnosed 1993–2005 vs 2006–2023
- Outcome
- Changes in features and outcomes over 30 years
Methodological detailscomparison of two diagnosis periods
- Comparison of two diagnosis periods
Main finding
As reported in the abstract
- Mean age at systemic lupus erythematosus (SLE) diagnosis significantly higher in group 1
- P < 0.001
- Age at LN diagnosis significantly higher in group 1
- P < 0.001
- Time to LN development significantly higher in group 1
- P = 0.049
- Mean delay time to diagnosis significantly higher in group 1
- P = 0.004
- Complete renal remission significantly more common in group 2
- P = 0.005
- End-stage kidney disease (ESKD) significantly more common in group 1
- P = 0.005
- Death significantly more common in group 1
- P = 0.001
Observational data: associations, not effects.
Further findings
Proliferative LN (class III and/or IV)
Baseline disease activity and aPL
- Baseline Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores higher in group 1
- P = 0.040
- aPL positivity more frequent in group 1
- P = 0.025
Treatment
- AZA in maintenance phase more frequent in group 1
- P = 0.016
- RTX more frequently used in group 2
- P = 0.042
Independent risk factors for progression to ESKD
- Proteinuria at first visit
- P = 0.037
- SLEDAI score at first visit
- P = 0.024
Original publication
How have the clinical, laboratory, treatment features and outcomes in children with lupus nephritis progressed over the last 30 years? Rheumatology (Oxford). Published 19 March 2025. doi:10.
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