Kidney Week

Abstract: PUB338

Kidney Involvement in Systemic Lupus Erythematosus (SLE): Beyond Lupus Nephritis

Session Information

• Publication Only

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Cohen-Hagai, Keren, Meir Medical Center, Kfar Saba, Central, Israel

Keren Cohen-Hagai, MD

• Benchetrit, Sydney, Meir Medical Center, Kfar Saba, Central, Israel

Sydney Benchetrit, MD

• Bar-Ziv, Dorin, Meir Medical Center, Kfar Saba, Central, Israel

Dorin Bar-Ziv, MD

• Kabaha, Mohamad, Meir Medical Center, Kfar Saba, Central, Israel

Mohamad Kabaha

• Shashar, Moshe, Laniado Hospital, Netanya, Central, Israel

Moshe Shashar, MD

• Tayer Shifman, Oshrat, Meir Medical Center, Kfar Saba, Central, Israel

Oshrat Tayer Shifman

Background

Systemic lupus erythematosus (SLE) frequently involves the kidneys, contributing to morbidity among this population and may result in chronic kidney disease (CKD).
While CKD diagnosis has significant clinical and therapeutic implications, it is still underdiagnosed even in high-risk population for CKD such as SLE.
We aimed to detect prevalence and long-term clinical outcomes of non-dialysis dependent CKD among SLE patients

Methods

A retrospective study, conducted between 2014–2023 and included adults with a diagnosis of SLE for at least 1 year. CKD was defined as either eGFR<60 ml/min/1.73m² or albuminuria persisting in ≥2 consecutive tests spaced at least 3 months apart

Results

A total of 162 SLE patients were included, of them 57 had albuminuria, 43 had eGFR<60, and 23 patients had both.
Out of the CKD patients, 61.1% never had a diagnosis of LN. Odds ratio for having CKD was 2.6 (95%CI 1.3-5.2, p=0.01) in patients with LN as cpmpared to patients without LN.
CKD was associated with higher rates of diabetes, hypertension and heart disease (p=0.03, <0.01, <0.01 respectively).
Rates of severe SLE exacerbations and severe infections were higher among CKD patients (p<0.01;<0.01).
Despite comparable follow-up time, CKD patients had significantly higher mortality rates vs. non-CKD (23.4% vs 0, p<0.001 on univariate and multivariate analysis (Figure 2, p<0.01)

Conclusion

CKD is prevalent among SLE patients, including those without diagnosed LN, and is associated with elevated rates of morbidities, disease exacerbations, and mortality. These findings underscore the importance of proactive monitoring and intervention to alleviate the substantial morbidity and mortality burden associated with CKD in SLE.

study flowchart

age- and sex-adjusted cox model