What Factors Cause Rapid Kidney Disease Progression in LN Patients?

A recent study identified factors associated with rapid progression to end stage kidney disease (ESKD) in patients with lupus nephritis (LN).

The researchers examined data from 10 patients from the Toronto Lupus Clinic, each of whom had biopsy-proven LN and developed ESKD within 3 years of LN diagnosis. These patients represented 1.8% of the total LN population. One patient had LN class II, 5 had class IV, 2 had class V, and 2 had mixed class IV/V.

Two of the patients had extensive thrombotic microangiopathy, 1 had collapsing glomerulonephritis, and 1 had concomitant antiglomerular basement membrane nephropathy. Four of the patients had no unusual kidney pathology. All of the participants showed severe treatment adherence.

“Catastrophic progression to ESKD is uncommon in LN. The major associated factors are poor compliance and distinct histopathologic features such as thrombotic microangiopathy, collapsing glomerulopathy, and concomitant anti-GBM nephropathy,” the authors concluded.

—Michael Potts

Reference:

Tselios K, Gladman DD, Taheri C, et al. Factors associated with rapid progression to endstage kidney disease in lupus nephritis. J Rheumatol. 2021;48(2):228-231. doi: 10.3899/jrheum.200161.