ArticleLupus science & medicine2022
Clinical and histological findings at second but not at first kidney biopsy predict end-stage kidney disease in a large multicentric cohort of patients with active lupus nephritis.
Article in Lupus science & medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 24 citations in OpenAlex.
- Kidney Biopsy and Prognosis in Lupus Nephritis: Histological Predictors of Renal Outcome-A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Urinary Exosomes as Potential Biomarkers for Diagnosis, Disease Activity Assessment, Treatment Monitoring, and Prognosis in Lupus Nephritis.International journal of molecular sciences · 2026Review
- Repeat Kidney Biopsy in Lupus Nephritis: Diagnostic Yield and Clinical Utility in a Real-World Single-Centre Cohort.Journal of clinical medicine · 2026Article
- Advancing Care in Lupus Nephritis: Expert Perspectives on Current Practices and Future Directions in Italy.Journal of clinical medicine · 2026Review
- Characterizing the NIH Activity and Chronicity Indices in 2 Independent Lupus Nephritis Cohorts.Kidney international reports · 2026Article
- Trajectories of long-term eGFR and proteinuria in lupus nephritis: a real-world biopsy-proven cohort study.Lupus science & medicine · 2026Article
- Early antiproteinuric effect of voclosporin in patients with LN in a real-life setting: preliminary results from the VoRLiSS (Voclosporin in Real Life Setting Study) experience.Rheumatology (Oxford, England) · 2026Observational
- Not So Benign: Revisiting Pure Membranous Lupus Nephritis.Journal of personalized medicine · 2025Review
- Development and validation of nomograms for predicting activity index and tubulointerstitial lesions in lupus nephritis: a multicentre study.Lupus science & medicine · 2025Article
- Management of systemic lupus erythematosus with kidney involvement: systematic literature review to inform the 2025 update of EULAR recommendations.EULAR rheumatology open · 2025Review
- Repeat biopsies in membranous lupus nephritis in the era of target antigen identification.Virchows Archiv : an international journal of pathology · 2025Article
- Urinary soluble CD163 is useful as "liquid biopsy" marker in lupus nephritis at both diagnosis and follow-up to predict impending flares.Journal of translational autoimmunity · 2024Article
- Lupus nephritis-related chronic kidney disease.Nature reviews. Rheumatology · 2024Review
- Lupus Nephritis from Pathogenesis to New Therapies: An Update.International journal of molecular sciences · 2024Review
- Effect of Sustained Clinical Remission on the Risk of Lupus Flares and Impaired Kidney Function in Patients With Lupus Nephritis.Kidney international reports · 2024Article
- Kidney Biopsy in Management of Lupus Nephritis: A Case-Based Narrative Review.Kidney medicine · 2024Review
- Flares in Lupus Nephritis: Risk Factors and Strategies for Their Prevention.Current rheumatology reports · 2023Review
- Lupus Nephritis Risk Factors and Biomarkers: An Update.International journal of molecular sciences · 2023Review
- Disease modification achievement in patients with lupus nephritis in a real-life setting: mission impossible?RMD open · 2023Article
- Noninvasive Evaluation of Lupus Nephritis Activity Using a Radiomics Machine Learning Model Based on Ultrasound.Journal of inflammation research · 2023Article
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16 authors at 5 institutions in 1 country.
Funding
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Abstract
objectiveTo investigate second kidney biopsy as predictor of end-stage kidney disease (ESKD) in active lupus nephritis (LN).
methodsPatients with biopsy-proven LN (International Society of Nephrology/Renal Pathology Society 2003) who had undergone a second kidney biopsy between January 1990 and December 2018 were included. Clinical and histological findings at first and at second biopsy were analysed with Cox proportional hazard models to predict ESKD, defined as start of kidney replacement therapy. Survival curves were calculated with Kaplan-Meier method.
resultsNinety-two patients with LN were included, 87% females, mean follow-up 17.9±10.1 years. Reasons for second kidney biopsy encompassed nephritic flares (n=28, 30.4%), proteinuric flares (n=46, 50%) or lack of renal response (n=18, 19.5%). Class switch from first biopsy occurred in 50.5% of cases, mainly from non-proliferative towards proliferative classes. Class IV remained stable in over 50% of cases. Twenty-five patients (27.2%) developed ESKD, mostly belonging to the nephritic flare group (17/28, 60.7%). Independent predictors of ESKD at second biopsy were activity index (AI; (HR 95% CI) 1.20 (1.03 to 1.41), p=0.022), chronicity index (CI; 1.41 (1.09 to 1.82), p=0.008) and 24h-proteinuria (1.22 (1.04 to 1.42), p=0.013). AI≥2 (log-rank p=0.031), CI >4 (log-rank p=0.001) or proteinuria ≥3.5 g/day (log-rank=0.009) identified thresholds for higher ESKD risk. In a subgroup analysis, glomerular activity and tubular chronicity mostly accounted for AI and CI association with ESKD. No histological or laboratory predictors emerged at first biopsy (95% CI): AI: 0.88 to 1.19; CI: 0.66 to 1.20; proteinuria 0.85 to 1.08.
conclusionsFindings at second but not at first kidney biopsy in patients with persistently active or relapsing LN inform about ESKD development in a long-term follow-up.
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