ArticleFrontiers in immunology2025
Long-term prognosis of lupus nephritis: comparison between pediatric, adult, and advanced age onset.
Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Kidney Biopsy and Prognosis in Lupus Nephritis: Histological Predictors of Renal Outcome-A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Advancing Care in Lupus Nephritis: Expert Perspectives on Current Practices and Future Directions in Italy.Journal of clinical medicine · 2026Review
- Genetic and phenotypic landscape of monogenic lupus: insights from an international cohort.Lupus science & medicine · 2026Article
- Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices.Clinical and experimental pediatrics · 2026Article
- Clinical, laboratory, and histopathological characteristics of pediatric lupus nephritis: a retrospective study in a national referral center in Mexico.Frontiers in pediatrics · 2026Article
- Repeat kidney biopsy in pediatric lupus nephritis: an analysis of associated clinical-pathological features and outcomes.Frontiers in pediatrics · 2026Article
- Impact of high disease activity on damage accrual and disease outcomes in childhood-onset systemic lupus erythematosus.Frontiers in pediatrics · 2026Article
- Age-stratified risk factors and predictive models for progression to lupus nephritis in patients with systemic lupus erythematosus: a review.Frontiers in immunology · 2025Review
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11 authors.
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Abstract
Background and hypothesis: Lupus nephritis (LN) presents with varied outcomes depending on the age at diagnosis. We aimed to evaluate long-term kidney survival across three age groups. Methods: Patients were categorized based on their age at lupus nephritis diagnosis: ≤18 years (childhood), >18 to <45 (adulthood), and ≥45 years (elderly). The three groups' CKD (eGFR <60 ml/min/1.73 m Results: This retrospective cohort study analyzed 260 patients followed for a median of 14.8 years. Of them, 46 (17.7%) were <18, 173 (66.5%) >18 and <45, and 41 (15.8%) ≥45 years old. 46% of elderly vs. 32.6% of children and 24.3% of adults had acute kidney disease (AKD) at diagnosis (P=0.02). Children had more active SLE, whereas the elderly had more chronic damage and hypertension. At 5, 10, and 20 years, CKD or death-free survival rates were 95.3%, 92.5%, and 88.4% in children; 98.2%, 90.1%, and 82.6% in adults; and 87.5%, 67.8%, and 53.5% in the elderly, respectively. Survival in elderly patients was significantly worse compared with children and adults (P= 0.001), whereas survival rates between children and adults were comparable (P = NS). At multivariate analysis, when the chronicity index was excluded from the model, older age emerged as an independent predictor of CKD or death (relative risk, RR: 3.278; CI: 1.402-7.662; P=0.006), with AKD (RR: 2.930; CI: 1.674-5.130; P<0.001), arterial hypertension (RR: 3.692; CI: 1.844-7.389; P<0.001), SLICC >0 (RR: 1.824; CI: 1.155-2.881; P=0.01), and failure to achieve complete remission at 1 year (RR: 4.784; CI: 2.355-9.716; P<0.001). Conclusion: While children and adults demonstrate comparable long-term kidney survival, elderly patients face significantly worse outcomes due to advanced chronicity and systemic damage. These findings highlight the need for tailored interventions in late-onset LN. Older-onset LN, in fact, was an independent predictor of CKD or death together with AKD, arterial hypertension, SLICC >0, and no remission at 1 year.
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