Skip to main content

Predicting CKD Outcomes in Lupus Nephritis

An observational cohort study suggests that proteinuria levels in lupus nephritis (LN) patients did not predict their histologic class.

A multicentre observational study of patients with biopsy-proven LN; either proliferative (PLN) or membranous (MLN) lupus nephritis were compared regarding clinical and laboratory presentation and long-term outcomes. The primary outcome was progression to chronic kidney disease (CKD).

A total of 260 LN patients were included, with a median follow-up of 8 years. 

MLN patients had significantly lower serum creatinine (0.70 mg/dl vs 0.80, p= 0.003) than PLN at presentation.. 

Overall, proteinuria levels did not differ between groups (p= 0.641).  Moreover, proteinuria at diagnosis or at one year did not predict long term CKD progression. Nonetheless, lower proteinuria at diagnosis was more likely to achieve a complete renal response at one year. 

Levels of complement were reduced in PLN but nearly normal in MLN patients, and there were fewer patients with positive anti-dsDNA antibodies in the MLN group (p< 0.001). 

Estimated glomerular filtration rate (eGFR) ≤75 mL/min/1.73 m2 at one year was the strongest predictor of progression to CKD (HR 23 [95% CI 8–62], p< 0.001). 

Other predictors of CKD included the use of azathioprine , older age at diagnosis and male sex.


If you are a health practitioner, you may to comment.

Due to the nature of these comment forums, only health practitioners are allowed to comment at this time.

The author has no conflicts of interest to disclose related to this subject