Kidney Week

Abstract: PUB342

Characterization of Screening Patterns and Identification of Patients with Lupus Nephritis in a Community Rheumatology Setting

Session Information

• Publication Only

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Soloman, Nehad, Arizona Arthritis & Rheumatology Associates, P.C., Phoenix, Arizona, United States

Nehad Soloman, MD

• Bilal, Jawad, Arizona Arthritis & Rheumatology Associates, P.C., Phoenix, Arizona, United States

Jawad Bilal, MD

• Cabacungan, Romy, Arizona Arthritis & Rheumatology Associates, P.C., Phoenix, Arizona, United States

Romy Cabacungan, MD

• Milligan, Scott, Trio Health Analytics, Louisville, Colorado, United States

Scott Milligan, PhD

• Sharobeem, Andrew, Arizona Arthritis & Rheumatology Associates, P.C., Phoenix, Arizona, United States

Andrew Sharobeem, DO

• Tesser, John, Arizona Arthritis & Rheumatology Associates, P.C., Phoenix, Arizona, United States

John Tesser, MD

• Leher, Henry, Aurinia Pharmaceuticals Inc, Victoria, British Columbia, Canada

Henry Leher, PhD

Background

Lupus nephritis (LN) is a serious but common complication of systemic lupus erythematosus (SLE) characterized by proteinuria and decreased renal function. As delays in LN diagnosis may lead to nephron loss and delayed administration of disease-modifying therapies, current treatment recommendations suggest regular screening of patients with SLE for kidney involvement. Given the importance of early identification and treatment of LN, we assessed screening patterns for kidney involvement in patients with SLE in care of community rheumatologists in the United States.

Methods

Patient selection criteria: ≥2 diagnosis codes for SLE separated by >30 days, in care of the American Rheumatology Network (ARN) between July 2018 and June 2023, and >365 days observation. Individual patient observation windows were calculated from the first date of observation by ARN (index date) to the last encounter date, up to June 30, 2023. Patients were suspected of having probable LN if they had any of the following qualifying events during their observation window: an ICD-10 code for LN, an ICD-10 code suggestive of LN (e.g., kidney issues or related testing), or laboratory results indicative of proteinuria or reduction in estimated glomerular filtration rate (eGFR >20% less than observed at earliest observation and where lower eGFR measure is <72 mL/min/1.73 m² and not already categorized by ICD-10 code).

Results

8631 of >540,000 patients with data in the ARN database met all study criteria. Of these, 5314 (62%) had at least one qualifying event during their observation window; 24% of patients had a diagnosis of LN by ICD-10 code, whereas an additional 38% had laboratory values or other ICD-10 coding suggestive of LN. Of the 62% of patients with probable LN, 97% had record of an eGFR assessment compared to 66% and 62% of patients, respectively, who had record of protein assessment by urine test strip or urine protein.

Conclusion

This study suggests that most patients with SLE will develop renal involvement over the course of their disease. These data support increased routine screening of SLE patients for LN via regular utilization of urine protein testing, consistent with the LN treatment guidelines.

Funding

• Commercial Support – Aurinia Pharmaceuticals, Inc.