10 Surprising Insights on Lupus Nephritis and Chronic Kidney Disease Progression
Proteinuria levels do not predict the histologic class of lupus nephritis (LN), despite being a common measure of kidney function.
An estimated glomerular filtration rate (eGFR) cutoff of 75 mL/min/1.73 m² after 1 year of treatment strongly predicts progression to chronic kidney disease (CKD).
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder, with lupus nephritis occurring in approximately half of SLE patients.
Proliferative LN (PLN) and membranous LN (MLN) are linked to higher risks of end-stage renal disease and mortality.
Patients with MLN exhibited significantly lower serum creatinine levels compared to those with PLN (0.70 mg/dL vs 0.80 mg/dL).
Fewer MLN patients test positive for anti-double-stranded DNA antibodies compared to PLN patients (48% vs 92%).
After one year, 62% of patients achieved a complete renal response, with an additional 5% achieving a partial response.
Lower proteinuria levels at diagnosis are correlated with a higher likelihood of achieving a complete renal response.
Among the 6% of patients who died during the study, infection and cancer were the leading causes of death.
Cumulative survival rates for patients were 97% at 5 years, 93% at 10 years, 91% at 15 years, and 88% at 20 years.