ArticleJournal of nephrology2021
Renal thrombotic microangiopathy associated to worse renal prognosis in Lupus Nephritis.
Article in Journal of nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- II Brazilian Society of Rheumatology consensus for lupus nephritis diagnosis and treatment.Advances in rheumatology (London, England) · 2024Guideline
- Unveiling the Incidence and Graft Survival Rate in Kidney Transplant Recipients WithTransplant international : official journal of the European Society for Organ Transplantation · 2024Pooled it
- Kidney Biopsy and Prognosis in Lupus Nephritis: Histological Predictors of Renal Outcome-A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Renal thrombotic microangiopathy impairs renal function recovery in lupus nephritis.Clinical kidney journal · 2025Article
- Systematic Review of the Outcomes and Prognostic Factors of Patients With Systemic Lupus Erythematosus-Associated Thrombotic Microangiopathy.Kidney international reports · 2025Article
- Diagnostic Value of Biological Parameters in Biopsy-Confirmed Thrombotic Microangiopathy-MATRIX Consortium Group.Kidney international reports · 2025Article
- Perspective on Renal Involvement in Antiphospholipid Syndrome: Implications for Diagnosis, Pathogenesis, and Treatment.Journal of clinical medicine · 2025Review
- Renal vascular lesions in childhood-onset lupus nephritis.Pediatric nephrology (Berlin, Germany) · 2025Article
- [Update on lupus nephritis].Zeitschrift fur Rheumatologie · 2024Review
- Pregnancy as a susceptible state for thrombotic microangiopathies.Frontiers in medicine · 2024Review
- Vascular injury in glomerulopathies: the role of the endothelium.Frontiers in nephrology · 2024Review
- [Clinical characteristics and prognosis of 12 cases of lupus nephritis complicated with thrombotic microangiopathy].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2023Article
- Clinical-Pathological Characteristics of Renal Injuries Identify Different Clusters in Patients With Antiphospholipid Antibodies.Kidney international reports · 2023Article
- Thrombotic thrombocytopaenic purpura in the era of HIV: A single-centre experience.Southern African journal of HIV medicine · 2023Article
- Persistent Isolated C3 Hypocomplementemia as a Strong Predictor of End-Stage Kidney Disease in Lupus Nephritis.Kidney international reports · 2022Article
- Kidney thrombotic microangiopathy in lupus nephritis: Impact on treatment and prognosis.Lupus · 2022Article
- IgA nephropathy and atypical hemolytic uremic syndrome: a case series and a literature review.Journal of nephrology · 2022Review
- Deep Learning-Based Artificial Intelligence System for Automatic Assessment of Glomerular Pathological Findings in Lupus Nephritis.Diagnostics (Basel, Switzerland) · 2021Article
- The Relationship between Renal Interstitial Vasculopathy and Clinical and Prognosis of Patients with Lupus Nephritis.Kidney diseases (Basel, Switzerland)Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRenal thrombotic microangiopathy (rTMA) is one of many vascular findings in Lupus Nephritis (LN). However, the influence of rTMA on prognosis has not been well established. The objective of this study was to evaluate the clinical and pathological aspects of patients with lupus and rTMA in kidney biopsy.
methodsAnalysis of medical reports and kidney biopsy of 253 patients with LN, between January 2012 and December 2018.
resultsAmong our 253 patients, 43 (17%) showed acute or chronic TMA lesions on kidney histology This group had a significantly lower estimated glomerular filtration rate (eGFR) at the time of biopsy (24.1 vs. 64.15 ml/min/1.73m2, p < 0.001), at 1 year of follow up (28.1 vs. 90.7 ml/min/1.73m2, p < 0.001), and at the end of follow up (25.4 vs. 81.55 ml/min/1.73m2, p < 0.001). More patients in the rTMA group reached the composite endpoint of eGFR < 15 mL/min/1.73m2 or death or dialysis (82.9% vs. 32.9%, p < 0.001). When comparing the classical clinical TMA features, the rTMA group had higher percentages of anemia, thrombocytopenia, low haptoglobin levels, but not higher lactate dehydrogenase (LDH) levels (> 214 U/L). Combining these variables in a definition of clinical TMA, the rTMA group had a statistically higher percentage of clinical TMA (20.9% vs. 4.33%, p = 0.001). As expected, TMA group showed higher systolic blood pressure (SBP) (130 vs 129.5 mmHg, p = 0.01). Concerning histopathological features, rTMA group had significantly higher activity (9.0 vs. 6.0, p = 0.001) and chronicity (4.0 vs. 3.0, p = 0.001) scores, also a higher percentage of patients presented with crescents (76.7% vs. 57.1%, p = 0.012).
conclusionsThe classical clinical TMA criteria were unable to predict the presence of tissue TMA, suggesting a probably renal-limited TMA that may occur independently of systemic evident factors. Therefore, renal biopsy remains the critical method for diagnosing an important prognostic feature.
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