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Hanly and coworkers have reported the results of a large lupus cohort study involving 1827 patients. SLE patients were enrolled early in their disease (0.5 years) and were followed for a mean of 4.6 years.
Lupus nephritis (LN) was found in 38% patients, with 81% presenting with LN at enrolment and 19% during follow-up. LN was more likely in patients who were younger, male and ethnic (African, Asian or Hispanic).
For all lupus patients the overall 10-year incidence of ESRD was 4.3%, but in those with nephritis was ESRD occurred in 10.1%. Nephritis patients had a 3 fold higher risk of death (HR = 2.98, 95% CI: 1.48, 5.99.
Despite current standard of care, nephritis was associated with ESRD and death, and renal insufficiency was linked to lower health-related quality of life.