ArticleKidney international reports2026
Outcomes and Predictors of Treatment Response in Patients With Pure Lupus Membranous Nephropathy.
Article in Kidney international reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: The indications and modalities of therapeutic strategies for first-onset pure lupus membranous nephropathy (PLMN) remain poorly defined. We aimed to evaluate renal response rates across real-world treatment strategies and identify predictors of treatment response in PLMN. Methods: We conducted a multicenter retrospective study in 25 French centers. Patients with biopsy-proven first-onset PLMN treated between 2000 and 2020 were included. Patients were classified according to their initial treatment strategy. Renal response rates were defined based on the 2024 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Factors associated with treatment failure at 12 months were assessed using logistic regression. Results: Among 194 patients with PLMN, 53 (27.3%) received supportive care only, and 141 (72.7%) received immunosuppressive therapy (54 [38.3%] received mycophenolate mofetil (MMF)-based regimens, 26 [18.4%] received rituximab [RTX]-based regimens, and 61 [43.3%] received other treatments). At 12 months, rates of complete renal response (CRR) and CRR or partial renal (PRR) were respectively, 36.7% and 55.1% with supportive care, 47.1% and 60.8% with MMF, 64.0% and 72.0% with RTX, and 45.4% and 54.5% with other regimens. In multivariable analysis, the presence of anti-U1-ribonucleoprotein (U1RNP) antibodies was independently associated with treatment failure (adjusted odds ratio [OR]: 2.53; 95% confidence interval [CI]: 1.35-4.70; Conclusion: In patients with first-onset PLMN, 12-month renal response rates did not differ significantly among immunosuppressive regimens despite variation in treatment duration and steroid exposure. Anti-U1RNP antibodies and absence of extrarenal involvement were associated with a higher risk of treatment failure. Anti-CD20-based strategies may be a promising therapeutic approach.
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