ArticleClinical journal of the American Society of Nephrology : CJASN2011
Three decades of progress in treating childhood-onset lupus nephritis.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Management and outcomes in children with lupus nephritis in the developing countries.Pediatric nephrology (Berlin, Germany) · 2023Pooled it
- Pathogenesis, Treatment Advances, and Renal Outcomes in Childhood-Onset Lupus Nephritis.Clinical pediatrics · 2026Review
- Expert collaborative evidence-based consensus for childhood lupus nephritis diagnosis and treatment: unifying clinical approach in Saudi Arabia.Pediatric rheumatology online journal · 2026Article
- Prognostic factors for disease progression and mortality of childhood-onset lupus nephritis in the Philippines: a retrospective cohort study in a tertiary hospital.Pediatric rheumatology online journal · 2025Article
- Childhood-onset lupus nephritis: long-term outcomes and their predictors.Pediatric nephrology (Berlin, Germany) · 2025Article
- New Insights on Childhood Lupus Nephritis.International journal of nephrology and renovascular disease · 2025Review
- Extrapolation of the Efficacy and Pharmacokinetics of Belimumab to Support its Use in Children with Lupus Nephritis.Clinical pharmacokinetics · 2024Article
- Managing Lupus Nephritis in Children and Adolescents.Paediatric drugs · 2024Review
- A rare case of childhood-onset systemic lupus erythematosus associated end-stage renal disease with cerebral abscess and hemorrhage.Childhood kidney diseases · 2024Article
- Lupus Nephritis in Children: Novel Perspectives.Medicina (Kaunas, Lithuania) · 2023Review
- Does kidney biopsy in pediatric lupus patients "complement" the management and outcomes of silent lupus nephritis? Lessons learned from a pediatric cohort.Pediatric nephrology (Berlin, Germany) · 2023Observational
- Acute kidney injury requiring kidney replacement therapy in childhood lupus nephritis: a cohort study of the Pediatric Nephrology Research Consortium and Childhood Arthritis and Rheumatology Research Alliance.Pediatric nephrology (Berlin, Germany) · 2023Article
- Utility of the 2018 revised ISN/RPS thresholds for glomerular crescents in childhood-onset lupus nephritis: a Pediatric Nephrology Research Consortium study.Pediatric nephrology (Berlin, Germany) · 2022Article
- Principles of pediatric lupus nephritis in a prospective contemporary multi-center cohort.Lupus · 2021Review
- Mycophenolic acid area under the concentration-time curve is associated with therapeutic response in childhood-onset lupus nephritis.Pediatric nephrology (Berlin, Germany) · 2021Article
- Addition of cyclosporine/tacrolimus for pediatric relapsed lupus nephritis during mycophenolate mofetil maintenance therapy.The Journal of international medical research · 2019Article
- Combination therapy of rituximab and mycophenolate mofetil in childhood lupus nephritis.Pediatric nephrology (Berlin, Germany) · 2018Article
- Clinical presentation and outcomes of childhood-onset membranous lupus nephritis.Pediatric nephrology (Berlin, Germany) · 2017Article
- Proteinuria and progression of pediatric chronic kidney disease: lessons from recent clinical studies.Pediatric nephrology (Berlin, Germany) · 2017Review
- Advances in the care of children with lupus nephritis.Pediatric research · 2017Review
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Authors and funding
7 authors.
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Abstract
BACKGROUND AND
objectivesChildhood-onset lupus nephritis (LN) carries a worse renal prognosis compared with adults. Controlled treatment trials in children are lacking. We compared renal and patient survival in a cohort of pediatric patients followed over 3 decades. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: A retrospective analysis was conducted on 138 patients with childhood-onset systemic lupus erythematosus from 1980 to 2010. The core cohort included 95 with severe LN: 28 progressed to end-stage renal disease (ESRD group) whereas 67 did not (no-ESRD group). Patients were stratified into four "eras" according to the introduction of the primary immuno-suppressive drug: era 1: triple oral therapy with corticosteroids (CS), cyclophosphamide (CYC), and azathioprine (AZA); era 2: intravenous CYC; era 3: mycophenolate mofetil (MMF) ± CYC; era 4: rituximab (RTX) ± CYC ± MMF.
resultsMean age at diagnosis was 12.3 ± 2.9 years with median follow-up of 5 years. Poor renal function (estimated GFR < 60 ml/min per 1.73 m(2)) and nephrotic proteinuria at diagnosis imparted a poor prognosis. Increasing proteinuria correlated with progression of kidney disease. The addition of MMF in era 3 improved 5-year renal survival from 52% to 91% and overall patient survival from 83% to 97%. African-American ethnicity was associated with significant risk for progression to ESRD whereas Hispanic ethnicity conferred an advantage. Infection and cardiovascular disease were the primary causes of patient demise.
conclusionsRenal and patient survival in childhood-onset LN has improved during the past 3 decades with progressive treatment regimens. Future trials in children are very much warranted.
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