Evidence map›Paper›PMID 39700421›Full record

ArticleRheumatology (Oxford, England)2025

Renal arteriosclerosis in kidney biopsies associated with higher 10-year atherosclerotic cardiovascular disease in lupus nephritis.

Shivani Garg, Brad C Astor, S Sam Lim, Amish N Raval, Weixiong Zhong, Sarah E Panzer, Arezou Khosroshahi, Brad Rovin, Christie M Bartels

Erratum issuedAbstract read
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In one paragraph

Article in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Shivani GargDivision of Rheumatology, Department of Medicine, University of Wisconsin, Madison, WI, USA.ORCID 0000-0001-7272-2692
Brad C AstorDivision of Nephrology, Department of Medicine, University of Wisconsin, Madison, WI, USA.ORCID 0000-0002-0876-0069
S Sam LimDivision of Rheumatology, Department of Medicine, Emory University, Atlanta, GA, USA.
Amish N RavalDivision of Cardiology, Department of Medicine, University of Wisconsin, Madison, WI, USA.
Weixiong ZhongDepartment of Pathology, University of Wisconsin, Madison, WI, USA.
Sarah E PanzerDivision of Nephrology, Department of Medicine, University of Wisconsin, Madison, WI, USA.
Arezou KhosroshahiDivision of Nephrology, Department of Medicine, Ohio State University, Columbus, OH, USA.
Brad RovinDivision of Nephrology, Department of Medicine, Ohio State University, Columbus, OH, USA.
Christie M BartelsDivision of Rheumatology, Department of Medicine, University of Wisconsin, Madison, WI, USA.ORCID 0000-0001-6523-0374

Funding

University of Wisconsin Institute for Clinical and Translational ResearchUL1TR002373 · NCATS · UNIVERSITY OF WISCONSIN-MADISON · PI ELIZABETH S BURNSIDE, Allan R. Brasier · 2017 to 2026
$75.9M
Early and Personalized Cardiovascular Disease Preventive Care in Lupus Nephritis (EPiC-LN)K23AR084608 · NIAMS · YALE UNIVERSITY · PI SHIVANI GARG · 2024 to 2026
$512k
Clinical and Translational Science UL1TR002373Institute for Clinical and Translational ResearchNCATS NIH HHS UL1 TR002373NIAMS NIH HHS K23 AR084608NIH HHSNIH HHS 1K23AR084608-01University of Wisconsin-Madison
6 · The paper itself

Abstract

objectivePatients with lupus nephritis (LN), including those below age 50, face significantly higher risk of atherosclerotic cardiovascular disease (ASCVD) vs peers. This highlights the need for identifying specific ASCVD risk factors in LN. Renal arteriosclerosis in kidney biopsies (subclinical arteriosclerosis) may be able to predict future clinical ASCVD events. However, renal arteriosclerosis is under-reported in LN biopsies and is not taken into consideration when ASCVD risk is calculated. Therefore, we aimed to systematically grade renal arteriosclerosis in kidney biopsies at LN diagnosis and examined associations with 10-year and 20-year ASCVD occurrence.

methodsAdults with biopsy-proven LN were included. Clinical ASCVD, including fatal and non-fatal events, were adjudicated. Utilizing standard Banff grading criteria, all biopsies at LN diagnosis were re-read to grade renal arteriosclerosis. Covariables (e.g. socio-demographics, comorbidities, med exposure) were abstracted. Using Cox models, factors (including renal arteriosclerosis) associated with 10-year and 20-year clinical ASCVD were examined.

resultsAmong 209 patients, 36 and 49 clinical ASCVD occurred within 10 and 20 years. Renal arteriosclerosis (>25%) was associated with 3× higher 10-year ASCVD. High area deprivation index (>80) and longer angiotensin converting enzyme inhibitor (ACEi) exposure were associated with 4× higher and 0.65× lower ASCVD occurrence. Adding renal arteriosclerosis >25% improved model performance for 10-year ASCVD risk estimation from 65% to 80%. Similar associations were seen with 20-year ASCVD.

conclusionRenal arteriosclerosis >25%, area deprivation and ACEi exposure could inform ASCVD risk stratification in LN. Prospective studies should validate findings and inform clinical use.

Indexed as

ArteriosclerosisAtherosclerosisKidneyLupus NephritisAdultBiopsyFemaleHumansMaleMiddle AgedRisk Factorsadverse social factorsangiotensin converting enzyme inhibitorarea deprivation indexarteriosclerosiscardiovascularlupus nephritisrenal arteriosclerosis

Identifiers

PMID39700421
PMCPMC12048066

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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.