Trends in Lupus Nephritis Outcomes Have Plateaued

Five-year mortality and outcomes among patients with lupus nephritis (LN) have plateaued over the last 20 years, according to the authors of a recent study.

In order to evaluate changes in trends of development of end-stage renal disease (ESRD) and mortality rates among patients with LN over the last 40 years, researchers conducted an observational retrospective study of 219 patients divided into 4 groups based on timeframe of diagnosis: 1975-1985 (D1), 1986-1995 (D2), 1996-2005 (D3) and 2006-2015 (D4).

Over the 40-year period, changes in ethnic distribution were observed, with decreasing rates among White individuals (58.6% in D1 to 31.3% in D4) and increasing rates in individuals with African-ancestry (17.2% in D1 to 39.6% in D4). Five-year mortality rates decreased from D1 (24.1%) to D2 (4%), then stabilized for 30 years. Five-year progression to ESRD remained stable over the follow-up period.

“Despite the changes in treatment of LN in the past 20 years, we have reached a plateau in 5-year mortality and progression to end-stage renal disease rates, suggesting that new therapeutic and management approaches, and strategies to enhance adherence, are needed to improve outcomes further in LN patients,” the authors concluded.

—Michael Potts

Reference:

Gisca E, Duarte L, Farinha F, Isenberg DA. Assessing outcomes in a lupus nephritis cohort over a 40-year period. Rheumatology. 2021;60(4):1814-1822. doi: 10.1093/rheumatology/keaa491