Evidence map›Paper›PMID 34664621›Full record

ArticleRheumatology (Oxford, England)2022

History of proliferative glomerulonephritis predicts end stage kidney disease in pure membranous lupus nephritis.

Andrea Fava, Paride Fenaroli, Avi Rosenberg, Serena Bagnasco, Jessica Li, Jose Monroy-Trujillo, Derek Fine, Mohamed G Atta, Michelle Petri

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Rheumatology (Oxford, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.5field-weighted citation impact, top 17% of its field
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

10 citing papers in PubMed, 16 citations in OpenAlex.

  1. Review
  2. Review
  3. Not So Benign: Revisiting Pure Membranous Lupus Nephritis.Journal of personalized medicine · 2025
    Review
  4. Review
  5. Repeat biopsies in membranous lupus nephritis in the era of target antigen identification.Virchows Archiv : an international journal of pathology · 2025
    Article
  6. Review
  7. Article
  8. Review
  9. Article
  10. Article
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 at 2 institutions in 2 countries.

Andrea FavaDivision of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.ORCID 0000-0001-6738-4836
Paride FenaroliDivision of Nephrology, University Hospital, Parma, Italy.
Avi RosenbergDivision of Renal Pathology.
Serena BagnascoDivision of Renal Pathology.
Jessica LiDivision of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Jose Monroy-TrujilloDivision of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Derek FineDivision of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Mohamed G AttaDivision of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Michelle PetriDivision of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Johns Hopkins University · USUniversity of Parma · IT

Funding

Hopkins Lupus CohortR01AR069572 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI PETRI, MICHELLE A · 2016 to 2020
$3.4M
NIAMS NIH HHS R01 AR069572
6 · The paper itself

Abstract

objectivesPure membranous (class V) LN is considered a less aggressive phenotype, but tissue fibrosis and chronic kidney disease may still develop. This study aimed to elucidate the prognostic value of a history of class switch in pure membranous LN.

methodsWe included LN patients with at least two clinically indicated kidney biopsies. New onset of end stage kidney disease (ESKD) was defined as estimated glomerular filtration rate <15 ml/min/1.73 m2, initiation of dialysis or kidney transplantation.

resultsAmong 220 patients (542 biopsies), 199 (90%) were female, and 118 (54%) were African American, 59 (27%) Caucasian, with median age of 28 years at the first kidney biopsy. Patients with pure class V in a first biopsy converted to proliferative LN in 41% of cases. Pure class V in a repeat biopsy was preceded by proliferative LN in 52%. Trajectory analysis of up to four repeat biopsies revealed that ISN class switch may happen at any time, even after multiple biopsies with the same class. New onset ESKD was observed within 2 years in 5/56 (9%) patients with pure class V in a repeat biopsy. All five patients had proliferative LN in the first biopsy (log rank P = 0.024).

conclusionsThe conversion from proliferative to membranous (and vice-versa) is frequent in SLE. It can occur at any time in the course of disease, limiting the prognostic value of the first biopsy. Evidence of prior proliferative LN is key as it is associated with higher risk of ESKD in non-proliferative LN.

Indexed as

Glomerulonephritis, MembranousKidney Failure, ChronicLupus NephritisBiopsyFemaleGlomerular Filtration RateHumansKidneyMaleRetrospective StudiesESKDlupus nephritismembranousrepeat biopsySLE

Identifiers

PMID34664621
PMCPMC9308381
OpenAlexW3206419884

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.