Evidence map›Paper›PMID 26250434›Full record

ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2017

Histologic versus clinical remission in proliferative lupus nephritis.

Ana Malvar, Paola Pirruccio, Valeria Alberton, Bruno Lococo, Cecilia Recalde, Bernanda Fazini, Haikady Nagaraja, Divya Indrakanti, Brad H Rovin

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 127 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
127citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

127 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Biomarkers of Lupus Nephritis Histopathology: Where Do We Stand?Arthritis & rheumatology (Hoboken, N.J.) · 2026
    Pooled it
  2. Pooled it
  3. Guideline
  4. Trial
  5. Trial
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  8. A nomogram predicting the histologic activity of lupus nephritis from clinical parameters.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024
    Trial
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  10. Review
  11. Review
  12. Review
  13. Observational
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  15. Article
  16. Article
  17. Review
  18. Article
  19. Review
  20. Article

67 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ana MalvarHospital Fernandez, Buenos Aires, Argentina.
Paola PirruccioHospital Fernandez, Buenos Aires, Argentina.
Valeria AlbertonHospital Fernandez, Buenos Aires, Argentina.
Bruno LococoHospital Fernandez, Buenos Aires, Argentina.
Cecilia RecaldeHospital Fernandez, Buenos Aires, Argentina.
Bernanda FaziniHospital Fernandez, Buenos Aires, Argentina.
Haikady NagarajaCollege of Public Health, Ohio State University, Columbus, OH, USA.
Divya IndrakantiOhio State University Wexner Medical Center, Columbus, OH, USA.
Brad H RovinOhio State University Wexner Medical Center, Columbus, OH, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTreatment response in lupus nephritis (LN) is defined clinically, without consideration of renal histology. Few studies have systematically examined histologic responses to induction therapy. In LN patients who underwent protocol kidney biopsies after induction immunosuppression, we describe the renal histology of the second biopsy and correlate histologic activity and damage with short- and long-term kidney outcomes.

methodsPatients with suspected LN were biopsied for diagnosis (Biopsy 1), and those with proliferative LN were rebiopsied after induction (Biopsy 2). Histologic activity and damage at each biopsy were calculated as the National Institutes of Health activity and chronicity indices. Complete and partial renal responses after induction and after long-term follow-up were determined clinically.

resultsOne-third of patients who achieved a complete clinical response after induction had persistently high histologic activity, and 62% of patients who had complete histologic remission on rebiopsy were still clinically active. Chronic renal damage increased after induction even in complete clinical responders. Chronicity at Biopsy 2 associated with long-term kidney function and development of chronic kidney disease.

conclusionsEarly clinical and histologic outcomes are discordant in proliferative LN, and neither correlates with long-term renal outcome. The kidney accrues chronic damage rapidly and despite clinical response in LN. Preservation of kidney function may require therapeutic targeting of both chronic damage and inflammation during LN induction treatment.

Indexed as

AdultBiopsyFemaleHumansInflammationLupus NephritisMaleRemission InductionRenal Insufficiency, Chronicactivity indexchronicity indexkidney biopsylupus nephritisoutcomes

Identifiers

PMID26250434
PMCPMC5837387

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.