Lupus & antiphospholipid syndrome
Kidney outcomes in pure membranous versus proliferative lupus nephritis: A 14-year Latin American cohort study
Authors' conclusion
In this Latin American cohort, MLN exhibited a distinct baseline profile characterized by lower inflammatory activity and better-preserved kidney function at presentation. Although crude and competing-risk analyses suggested a more favorable renal trajectory for MLN, the study was underpowered to confirm an independent effect of MLN on ESKD after adjustment.
Study context
- Population
- Adults (≥18 years) with first biopsy-proven membranous lupus nephritis (MLN) or proliferative lupus nephritis (PLN) at a Colombian tertiary center
- Participants
- 371 adults
- Exposure
- Pure membranous LN vs proliferative LN
- MLNn = 54
- PLNn = 317reference
- Outcome
- End-stage kidney disease (ESKD)
Methodological detailssingle-centre (tertiary center), logistic regression, Kaplan-Meier analysis, Cox proportional hazards regression, competing-risks analysis (Fine-Gray, death as competing event)
- Single-centre (tertiary center)
- Logistic regression
- Kaplan-Meier analysis
- Cox proportional hazards regression
- Competing-risks analysis (Fine-Gray, death as competing event)
Main finding
As reported in the abstract
ESKD
MLN vs PLNEstimate (95% CI)
Univariable Cox; not confirmed in multivariable analysis (underpowered, only 2 ESKD events in MLN)
HR 0.12(0.03–0.48)
Unadjusted, competing-risks
SHR 0.13(0.03–0.51)
Adjusted for baseline eGFR and modified NIH indices
adjusted SHR 0.46(0.11–2.00)
Observational data: associations, not effects.
Further findings
Factors associated with MLN (multivariable logistic regression)
- Higher eGFR, OR
- 1.02 (95% CI 1.01-1.03)
- Anti-dsDNA positivity, OR
- 0.33 (95% CI 0.15-0.71)
Baseline features at biopsy
- MLN had lower immunological activity, better kidney function, less active urinary sediment and lower modified NIH activity and chronicity indices than PLN
Original publication
Kidney outcomes in pure membranous versus proliferative lupus nephritis: A 14-year Latin American cohort study. Lupus. Published 5 June 2026. doi:10.
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