Kidney Week

Abstract: TH-PO665

Assessing Chronicity Index on Kidney Biopsies of Patients with Lupus Nephritis and Its Correlation with Creatinine and Proteinuria at 1-Year Follow-Up

Session Information

• Lupus Nephritis: Clinical, Outcomes, and Therapeutics
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Kassar, Liliana M L, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil

Liliana M L Kassar, MD

• Carvalho Barros Sousa, Felipe, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil

Felipe Carvalho Barros Sousa, MD

• Silva, Karoline W C, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil

Karoline W C Silva, MD

• Silveira, Vinícius Sousa da, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil

Vinícius Sousa da Silveira, MD

• Gonçalves, José Guilherme Rezende Ramos Salles, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil

José Guilherme Rezende Ramos Salles Gonçalves, MD

• Woronik, Viktoria, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil

Viktoria Woronik, MD

• Yu, Luis, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil

Luis Yu, MD, PhD

• Dias, Cristiane B., Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil

Cristiane B. Dias, MD

• Jorge, Lectícia, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil

Lectícia Jorge, MD, PhD

Background

Lupus nephritis is a common manifestation of sistemic lupus erithematous and is associated with higher mortality, specially on those who progress to end-stage kidney disease. This study aims to assess chronicity index on initial kidney biopsy as a prognostic factor in lupus nephritis by correlating it to creatinine and proteinuria after 1-year follow-up.

Methods

Patients diagnosed with lupus nephritis between January 2012 and December 2018 were included. Study variables comprised age, gender, creatinine, estimated glomerular filtration rate (eGFR) by CKD-EPI, proteinuria, histological class and chronicity index on renal biopsy.

Results

A total of 253 renal biopsies were performed on the studied period, 86% in women. Mean age was 31 years old (13-70), initial serum creatinine 1.3 mg/dL (0.3-8.0) and final 1.47mg/dL (0.4-13.2). Average eGFR was 58 mL/min (4-156) at the time of kidney biopsy and 82mL/min (4-156) a year later, with average proteinuria going from 1.9g (0.1-10.7) on initial measure to 0.37g (0.04-6.9) after 1 year. Median chronicity index on kidney biopsy was 3 (0-10). Spearman correlation between chronicity index and creatinine after 1 year was 0.538 with p < 0.001, and with proteinuria was 0.144 with p 0.047. Chronicity index ≤ 4 was associated with lower proteinuria (p 0.02) and lower creatinine (p < 0.001) at 1 year of follow-up.

Conclusion

Patients with high chronicity indices at diagnosis present worse renal function and higher levels of proteinuria during follow-up. Supportive care and degree of immunosuppression in the setting of chronic and irreversible histologic lesions are topics that need more attention in such scenarios.