Observational studyPediatric nephrology (Berlin, Germany)2023
Chronic kidney disease in patients with childhood-onset systemic lupus erythematosus.
Observational study in Pediatric nephrology (Berlin, Germany), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 15 citations in OpenAlex.
- Factors associated with renal relapse in lupus nephritis after remission: a systematic review and meta-analysis.International urology and nephrology · 2026Review
- Serum total cholesterol, calcium, and IgG as discriminatory markers of lupus nephritis in children with systemic lupus erythematosus.Frontiers in pediatrics · 2026Article
- Childhood-onset lupus nephritis: long-term outcomes and their predictors.Pediatric nephrology (Berlin, Germany) · 2025Article
- Developing a Label-Free Infrared Spectroscopic Analysis with Chemometrics and Computational Enhancement for Assessing Lupus Nephritis Activity.Biosensors · 2025Article
- Renal vascular lesions in childhood-onset lupus nephritis.Pediatric nephrology (Berlin, Germany) · 2025Article
- New Insights on Childhood Lupus Nephritis.International journal of nephrology and renovascular disease · 2025Review
- Childhood-Onset Systemic Lupus Erythematosus (cSLE): An International Perspective.Current allergy and asthma reports · 2024Review
- Efficacy and safety of belimumab combined with the standard regimen in treating children with lupus nephritis.European journal of pediatrics · 2024Article
- Managing Lupus Nephritis in Children and Adolescents.Paediatric drugs · 2024Review
- Lupus Nephritis in Children: Novel Perspectives.Medicina (Kaunas, Lithuania) · 2023Review
Corrections and comments
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Authors and funding
34 authors at 19 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLupus nephritis (LN) is a frequent manifestation of childhood-onset systemic lupus erythematosus (cSLE) with a potential risk for kidney failure and poor outcomes. This study aimed to evaluate stages III, IV, and V of chronic kidney disease (CKD) and investigate risk factors for CKD in cSLE patients.
methodsWe performed a nationwide observational cohort study in 27 pediatric rheumatology centers, including medical charts of 1528 cSLE patients. Data were collected at cSLE diagnosis, during follow-up, and at last visit or death, between September 2016 and May 2019.
resultsOf 1077 patients with LN, 59 (5.4%) presented with CKD, 36/59 (61%) needed dialysis, and 7/59 (11.8%) were submitted for kidney transplantation. After Bonferroni's correction for multiple comparisons (p < 0.0013), determinants associated with CKD were higher age at last visit, urinary biomarker abnormalities, neuropsychiatric involvement, higher scores of disease activity at last visit and damage index, and more frequent use of methylprednisolone, cyclosporine, cyclophosphamide, and rituximab. In the regression model analysis, arterial hypertension (HR = 15.42, 95% CI = 6.12-38.83, p ≤ 0.001) and biopsy-proven proliferative nephritis (HR = 2.83, 95%CI = 1.70-4.72, p ≤ 0.001) increased the risk of CKD, while children using antimalarials had 71.0% lower CKD risk ((1.00-0.29) × 100%) than children not using them. The Kaplan-Meier comparison showed lower survival in cSLE patients with biopsy-proven proliferative nephritis (p = 0.02) and CKD (p ≤ 0.001).
conclusionsA small number of patients manifested CKD; however, frequencies of dialysis and kidney transplantation were relevant. This study reveals that patients with cSLE with hypertension, proliferative nephritis, and absence of use of antimalarials exhibited higher hazard rates of progression to CKD. A higher resolution version of the Graphical abstract is available as Supplementary information.
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