Lupus & antiphospholipid syndrome
Risk of chronic kidney disease in 260 patients with lupus nephritis: analysis of a nationwide multicentre cohort with up to 35 years of follow-up
Main finding · Predictor of progression to CKD: eGFR ≤75 mL/min/1.73 m² at one yearResult — go to the resultHazard ratio 23 95% CI 8–62Authors' conclusion
Proteinuria levels did not predict LN histologic class in our cohort. eGFR cutoff of 75 mL/min/1.73 m2 after one year of treatment was strongly predictive of progression to CKD.
Study context
- Population
- Patients with biopsy-proven lupus nephritis (LN) in the Rheumatic Diseases Portuguese Registry (Reuma.pt)median follow-up 8 years
- Participants
- 260 patients
- Exposure
- Proliferative vs membranous LN
- Outcome
- Progression to CKD (predictors)
Methodological detailsmulticentre, observational, nationwide registry (Reuma.pt), Cox regression
- Multicentre
- Observational
- Nationwide registry (Reuma.pt)
- Cox regression
Main finding
As reported in the abstract
Predictor of progression to CKD: Estimated glomerular filtration rate (eGFR) ≤75 mL/min/1.73 m² at one year
Hazard ratio
23
95% CI 8–62
P < 0.001
Proliferativevs membranous LN
HR 23 (95% CI 8–62); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | PLN | MLN | P value |
|---|---|---|---|
| Serum creatinine at presentationMLN vs PLN · significantly lower in MLN | 0.80 (IQR 0.31) mg/dl | 0.70 (IQR 0.20) mg/dl | P = 0.003 |
| Range | 0.26–2.60 | 0.50–1.30 |
- Proteinuria at presentation · MLN vs PLN · did not differ
- P = 0.641
- Positive anti-dsDNA antibodies · MLN vs PLN · fewer in MLN
- P < 0.001
Positive anti-dsDNA antibodies
- Complement reduced in PLN, nearly normal in MLN
EULAR/ERA-EDTA renal response · 1 year
- Complete response
- 62%
- Partial response
- 5%
- Lower proteinuria at diagnosis more likely to achieve complete response
Original publication
Risk of chronic kidney disease in 260 patients with lupus nephritis: analysis of a nationwide multicentre cohort with up to 35 years of follow-up. Rheumatology (Oxford). Published 22 April 2024. doi:10.
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