ArticleLupus science & medicine2022
Predictors of increase in chronicity index and of kidney function impairment at repeat biopsy in 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 14 papers.
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14 citing papers in PubMed, 21 citations in OpenAlex.
- Kidney Biopsy and Prognosis in Lupus Nephritis: Histological Predictors of Renal Outcome-A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Repeat Kidney Biopsy in Lupus Nephritis: Diagnostic Yield and Clinical Utility in a Real-World Single-Centre Cohort.Journal of clinical medicine · 2026Article
- Article
- The Evolution of Lupus Nephritis Therapy from the 1960s to the Present.Bioengineering (Basel, Switzerland) · 2026Review
- Predictors of Long-term Response in Patients With Lupus Nephritis.Kidney international reports · 2026Article
- Characterizing the NIH Activity and Chronicity Indices in 2 Independent Lupus Nephritis Cohorts.Kidney international reports · 2026Article
- Urine proteins reveal distinct coagulation and complement cascades underlying acute versus chronic lupus nephritis.The Journal of clinical investigation · 2025Article
- Clinical and immunological biomarkers can identify proliferative changes and predict renal flares in lupus nephritis.Arthritis research & therapy · 2025Article
- Repeat renal biopsy findings in 82 lupus nephritis patients: a clinicopathological study.International journal of clinical and experimental pathology · 2025Article
- Lupus nephritis randomised controlled trials: evidence gaps and under-represented groups.Lupus science & medicine · 2024Article
- Effect of Sustained Clinical Remission on the Risk of Lupus Flares and Impaired Kidney Function in Patients With Lupus Nephritis.Kidney international reports · 2024Article
- Optimal treatment targets for lupus nephritis using per-protocol repeat kidney biopsy findings at 2 years and clinical data up to 5 years: a single-center observational study.Therapeutic advances in chronic disease · 2024Article
- Flares in Lupus Nephritis: Risk Factors and Strategies for Their Prevention.Current rheumatology reports · 2023Review
- Searching for a prognostic index in lupus nephritis.European journal of medical research · 2023Article
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8 authors at 5 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesBased on available data, the histological predictors of long-term outcome of lupus nephritis (LN) are not clearly defined. Aims of this retrospective study were: (i) to evaluate the change of chronicity index from the first to second kidney biopsy and to find the predictors of chronicity index increase and (ii) to detect the clinical/histological features at first and at second kidney biopsy associated with long-term kidney function impairment.
methodsAmong 203 biopsy proven LN subjects, 61 repeated kidney biopsy 49 months after the first biopsy. The reasons for repeated biopsy were: nephritic flares in 25 (41%), proteinuric flares in 21 (36%) of patients and protocol biopsy in 14 (23%) of cases.
resultsDuring 23-year follow-up, 25 patients presented a decrease in glomerular filtration rate (eGFR) ≥30%. At repeat biopsy, chronicity index increased in 44 participants (72%) and did not increase in 17 (28%). Nephritic syndrome and serum creatinine >1.6 mg/dL at presentation correlated with chronicity index increase (p=0.031, 0.027, respectively), cyclophosphamide therapy tended to protect against chronicity index increase (p=0.059). Kidney flares occurred in 53.6% of patients with vs 23.5% of those without chronicity index increase (p=0.035). Chronicity index increases of 3.5 points in patients with kidney flares vs 2 in those without flares (p=0.001). At second, but not at first kidney biopsy, two different models predicted eGFR decrease at multivariate analysis. The first included activity index >3 (OR: 3.230; p=0.013) and chronicity index >4 (OR: 2.905; p=0.010), and the second model included moderate/severe cellular/fibrocellular crescents (OR: 4.207; p=0.010) and interstitial fibrosis (OR: 2.525; p=0.025).
conclusionAt second biopsy, chronicity index increased in 3/4 of participants. Its increase was predicted by kidney dysfunction at presentation and occurrence of LN flares. Kidney function impairment was predicted by both activity and chronicity index and by some of their components at repeated biopsy, but not at first biopsy.
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