Lupus & antiphospholipid syndrome
Lessons from a specialized lupus clinic: Presentation and damage outcomes in inception vs. prevalent lupus nephritis cohorts
Main finding · Composite renal damageResult — go to the resultAdjusted hazard ratio 1.00Authors' conclusion
Renal and non-renal damage are highly prevalent in LN patients. Extra-renal damage is greater in the prevalent cohort, likely reflecting prior disease activity and higher cumulative exposure to immunosuppressive therapies, particularly glucocorticoids, before clinic entry.
Study context
- Population
- Patients with lupus nephritis (LN) (initial documented LN event) from a longitudinal specialized lupus clinic
- Participants
- 526 patients
- Exposure
- Inception vs prevalent LN cohorts
- Inceptionn = 246
- Prevalentn = 280reference
- Outcome
- Composite:
- Renal damage (end-stage kidney disease or sustained ≥40% eGFR decline)
- Extra-renal damage accrual (increase in non-renal SDI)
Methodological detailslongitudinal specialized lupus clinic, Cox proportional hazards models adjusted for confounders
- Longitudinal specialized lupus clinic
- Cox proportional hazards models adjusted for confounders
Main finding
Composite renal damage · median follow-up 8.3 years
Adjusted hazard ratio
1.00
P = 0.99
Events by group
As reported in the abstract
Observational data: associations, not effects.
Further findings
Immunosuppressive use · baseline
P = 0.01
Median
| Outcome | Inception | Prevalent | aHR | P value |
|---|---|---|---|---|
| Co-primary: extra-renal damage accrual | 0.67 | P = 0.04 | ||
| Baseline chronicity index | 2.0 | 3.0 | P < 0.01 |
Baseline renal function and LN histologic class
- Similar between cohorts
Original publication
Lessons from a specialized lupus clinic: Presentation and damage outcomes in inception vs. prevalent lupus nephritis cohorts. Semin Arthritis Rheum. Published 13 September 2026. doi:10.
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