ArticleRheumatology (Oxford, England)2022
High incidence of proliferative and membranous nephritis in SLE patients with low proteinuria in the Accelerating Medicines Partnership.
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 14 papers.
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Who cites it
14 citing papers in PubMed.
- Long-term outcomes and treatments for proliferative lupus nephritis with low-level proteinuria: a multicentre retrospective study in Japan.Lupus science & medicine · 2026Article
- Urinary Exosomes as Potential Biomarkers for Diagnosis, Disease Activity Assessment, Treatment Monitoring, and Prognosis in Lupus Nephritis.International journal of molecular sciences · 2026Review
- Predominant HLA class I associations with lupus nephritis susceptibility, histology class and reduced renal function in patients with systemic lupus erythematosus: a retrospective case-control study.Rheumatology international · 2026Article
- A population-scale atlas of blood and tissue in lupus nephritis.bioRxiv : the preprint server for biology · 2026Article
- Clinical and Biochemical Factors Associated with Delayed Renal Response in Proliferative Lupus Nephritis: A 20-Year Single-Center Multiethnic Cohort Study.Biomedicines · 2026Article
- Management of systemic lupus erythematosus with kidney involvement: systematic literature review to inform the 2025 update of EULAR recommendations.EULAR rheumatology open · 2025Review
- Neutrophil Heterogeneity Identifies an Association of LAMP1 With Proliferative Lupus Nephritis.European journal of immunology · 2025Article
- Extrarenal symptoms associate with worse quality of life in patients enrolled in the AMP RA/SLE Lupus Nephritis Network.Rheumatology (Oxford, England) · 2025Observational
- Evaluation and randomised controlled trial of home urinalysis testing in patients with SLE at elevated risk for developing lupus nephritis: a study protocol.Lupus science & medicine · 2024Article
- Observational
- Longitudinal patterns and predictors of response to standard-of-care therapy in lupus nephritis: data from the Accelerating Medicines Partnership Lupus Network.Arthritis research & therapy · 2024Article
- Kidney Biopsy in Management of Lupus Nephritis: A Case-Based Narrative Review.Kidney medicine · 2024Review
- Urine proteomic signatures of histological class, activity, chronicity, and treatment response in lupus nephritis.JCI insight · 2024Article
- Spontaneous abortion as differential diagnosis of intermittent glomerular proteinuria in inactive systemic lupus erythematosus.Clinical case reports · 2023Article
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Abstract
objectiveDelayed detection of LN associates with worse outcomes. There are conflicting recommendations regarding a threshold level of proteinuria at which biopsy will likely yield actionable management. This study addressed the association of urine protein:creatinine ratios (UPCR) with clinical characteristics and investigated the incidence of proliferative and membranous histology in patients with a UPCR between 0.5 and 1.
methodsA total of 275 SLE patients (113 first biopsy, 162 repeat) were enrolled in the multicentre multi-ethnic/racial Accelerating Medicines Partnership across 15 US sites at the time of a clinically indicated renal biopsy. Patients were followed for 1 year.
resultsAt biopsy, 54 patients had UPCR <1 and 221 had UPCR ≥1. Independent of UPCR or biopsy number, a majority (92%) of patients had class III, IV, V or mixed histology. Moreover, patients with UPCR <1 and class III, IV, V, or mixed had a median activity index of 4.5 and chronicity index of 3, yet 39% of these patients had an inactive sediment. Neither anti-dsDNA nor low complement distinguished class I or II from III, IV, V or mixed in patients with UPCR <1. Of 29 patients with baseline UPCR <1 and class III, IV, V or mixed, 23 (79%) had a UPCR <0.5 at 1 year.
conclusionIn this prospective study, three-quarters of patients with UPCR <1 had histology showing class III, IV, V or mixed with accompanying activity and chronicity despite an inactive sediment or normal serologies. These data support renal biopsy at thresholds lower than a UPCR of 1.
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