Lupus & antiphospholipid syndrome
Predictors of long-term renal survival and mortality in patients with proliferative and membranous lupus nephritis
Authors' conclusion
Our study indicates that antiphospholipid antibodies, higher histologic activity and chronicity indices, and sustained high disease activity beyond renal items were independently associated with progression to ESRD. Mortality was increased among patients with ESRD and those with persistent high disease activity.
Study context
- Population
- Korean patients with biopsy-proven proliferative or membranous LN from a prospective cohort of 1497 patients with systemic lupus erythematosus (SLE)
- Participants
- 599 patients
- Exposure
- Predictors of end-stage renal disease (ESRD) and mortality in proliferative and membranous LN
- Proliferative LNn = 509
- Membranous LNn = 90
- Outcome
- Progression to ESRD (renal survival) and mortality
Methodological detailsmultivariate logistic regression, biopsy-proven LN
- Multivariate logistic regression
- Biopsy-proven LN
Main finding
As reported in the abstract
Predictors of progression to ESRD (multivariate logistic regression)
- Progressed to ESRD
- 42 (7.0%)
- Died
- 31 (5.2%)
- Antiphospholipid antibody positivity, OR
- 3.18, p = .023
- Higher activity index at biopsy, OR
- 1.14, p = .034
- Higher chronicity index at biopsy, OR
- 1.33, p = .042
- Sustained high disease activity (extra-renal adjusted mean SLEDAI-2K ≥ 3), OR
- 4.33, p = .019
Observational data: associations, not effects.
Further findings
Renal response and ESRD risk
- 12-month treatment response: significant association
- P < 0.001
- 6-month renal response: no association with ESRD risk
Renal survival by histologic indices
- Poorer with activity index ≥6
- P = 0.013
- Poorer with chronicity index ≥4
- P = 0.002
Overall survival / mortality
- Worse overall survival in patients who developed ESRD
- P = 0.028
- Higher adjusted mean SLEDAI-2K, HR
- 1.43, p < .0001
- Higher extra-renal adjusted mean SLEDAI-2K, HR
- 1.83, p < .0001
Original publication
Predictors of long-term renal survival and mortality in patients with proliferative and membranous lupus nephritis. Lupus. Published 7 January 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →