COEXISTING TUBULOINTERSTITIAL INFLAMMATION AND DAMAGE IS A RISK FACTOR FOR CHRONIC KIDNEY DISEASE IN PATIENTS WITH LUPUS NEPHRITIS: RESULTS FROM THE KORNET REGISTRY
Abstract: OP0228 (2023)
Authors: DJ. Park et al.
Key content:
An increasing body of evidence suggests a prognostic role of tubulointerstitial lesions in patients with lupus nephritis (LN). Although persistent tubulointerstitial inflammation (TII) usually precedes tubulointerstitial damage (TID) in LN, the two conditions 175 LN patients from the KORNET registry were divided into two groups: those with and without coexisting TII/TID. 62.9% had coexisting TII/TID and 37.1% did not. Patients with coexisting TII/TID were older, had higher ESR and 24 h proteinuria, and lower eGFR and hemoglobin levels than those without coexisting TII/TID. Anti-Ro and ribosomal-P antibodies were detected less frequently in patients with coexisting TII/TID. Patients with coexisting TII/TID more often had LN of the proliferative type and a larger proportion had a chronicity score > 4. During a mean follow-up of 89.9 months, CKD and ESRD developed more frequently in patients with than without coexisting TII/TID. Finally, the coexisting TII/TID was associated with a higher risk for CKD progression: adjusted hazard ratio (HR) = 2.677, for all LN patients.
Relevance:
LN patients with coexisting TII/TID are at greater risk for deterioration of kidney function at LN onset and for developing chronic kidney disease over the long-term. Although the therapeutic implementation of this finding is yet unclear, these findings provide another argument for kidney biopsies in SLE patients with suspected LN.
