ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0639

Kidney Transplantation In Lupus Nephritis. Multicenter Study Of 103 Patients

Vanesa Calvo-Río1, Lara Sánchez Bilbao1, Carmen Secada-Gómez1, Paúl Hernández Velasco2, Celia González-García3, Enrique Morales4, María Galindo-Izquierdo5, Sebastián Sandoval-Moreno6, Josefina Cortés-Hernández7, César Antonio Egües Dubuc8, Niccolo Viveros-Pérez9, María Caeiro10, Adrián Mayo-Juanatey11, Miriam Retuerto Guerrero12, María Camila Osorio-Sanjuan13, Luis Sala14 and Ricardo Blanco1, 1Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Immunopathology Group, Santander, Spain, Santander, Cantabria, Spain, 2Nephrology, Hospital Universitario 12 de Octubre, Madrid. Spain, Madrid, Madrid, Spain, 3Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Madrid, Spain, 4Nephrology, Hospital Universitario 12 de Octubre, Madrid, Madrid, Spain, 5Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain, Madrid, Madrid, Spain, 6Hospital Universitario Vall D'Hebron, Barcelona, Spain, 7Hospital Universitari Vall d’Hebron-Universitat Autónoma de Barcelona, Barcelona, Spain, 8Donostia University Hospital, San Sebastián, Pais Vasco, Spain, 9Hospital Universitario Germans Trias i Pujol, Badalona, Spain, 10Centro Hospitalario Universitario de Pontevedra, Pontevedra, Spain, 11Hospital Universitario Doctor Peset, Valencia, Comunidad Valenciana, Spain, 12Complejo Asistencial Universitario de León, Leon, Castilla y Leon, Spain, 13Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain, 14Hospital Universitario de Torrejón, Madrid, Spain

Meeting: ACR Convergence 2025

Keywords: , ,

Session Information

Date: Sunday, October 26, 2025

Title: (0593–0640) Systemic Lupus Erythematosus – Diagnosis, Manifestations, & Outcomes Poster I

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: Lupus nephritis (LN) is a serious complication of systemic lupus erythematosus (SLE) affecting to 40-60% of SLE. End-stage renal disease (ESRD) occurs in up to 10-20% of LN, occasionally requiring kidney transplantation (KT) [1].In a series of LN patients who underwent KT, our aim was to assess a) clinical and histological features, b) frequency of renal graft loss, and c) SLE and LN flares.

Methods: Multicenter study of all consecutive patients who underwent KT due to LN in 10 Spanish reference University hospitals between January 1980 and December 2023. Demographic, epidemiological, clinical, analytical and histological data on SLE and LN were collected. In addition, cases of graft loss and their causes, as well as LN flares, were recorded.

Results: We include 103 (80 women, 77.7%), patients; mean age of 38.6±17.1 years. When KT was performed, the main clinical manifestations were joint (n=54; 52.4%) and mucocutaneous involvement (n=44, 42.7%). The predominant histological diagnosis of LN was class IV (n= 47, 45.6%), followed by class III (n=12; 11.6%). The main general features are summarized in TABLE 1.The subtypes of renal replacement therapy (RRT) used prior to KT were: hemodialysis (n=67, 65%), peritoneal dialysis (n=17, 16.5%), combined therapy (n=9, 8.7%) The median [IQR] time from initiation of RRT to KT was 3 years [1-5].The most frequently reported types of donations were brain death (n=45, 43.7%) and asystole (n=29, 28.2%). Renal graft loss was observed in 31 (30.1%) patients. The most common causes were: acute rejection (n=11, 35.5%), chronic rejection (n=8, 25.8%), combined acute and chronic rejection (n=5, 16.2%), graft thrombosis (n=4, 12.9%) (TABLE 2).In most patients, the graft remains functional (n= 65; 63%). A SLE flare was observed in 17 (13.1%) patients, with renal involvement in 6 (5.8%) cases. LN flare in the graft was the cause of organ loss in only 3 patients (9.7%).

Conclusion: Despite concerns about the recurrence of LN after KT, our results indicate that graft loss is lower in our cohort compared to other published series, and that LN recurrence in the graft is not a frequent cause of organ lossREFERENCES1. ZHANG L et al.: Long-term outcomes of end-stage kidney disease for pa­tients with lupus nephritis. Kidney Int 2016; 89: 1337-45.

Supporting image 1TABLE 1. MAIN GENERAL FEATURES OF THE 103 PATIENTS UNDERWENT TO KIDNEY TRASNPLANTATION.

Abbreviations: SD: Standard Deviation; LN: Lupus Nephritis; RRT: Renal Replacement Therapy; IQR: Interquartile RangeTABLE 2. KIDNEY TRANSPLANT COMPLICATIONS AND EVOLUTION

Supporting image 2TABLE 2. KIDNEY TRANSPLANT COMPLICATIONS AND EVOLUTION.

Abbreviations: LN: Lupus Nephritis

Disclosures: V. Calvo-Río: AstraZeneca, 6, MSD, Roche, AbbVie, Lilly, Celgene, Grünenthal, and UCB Pharma, 2, 6; L. Sánchez Bilbao: AbbVie/Abbott, 6, Eli Lilly, 6, Janssen, 6, UCB, 6; C. Secada-Gómez: None; P. Hernández Velasco: None; C. González-García: None; E. Morales: None; M. Galindo-Izquierdo: None; S. Sandoval-Moreno: None; J. Cortés-Hernández: AstraZeneca, 6, Bristol-Myers Squibb (BMS), 1, GlaxoSmithKline (GSK), 6, Novartis, 1, 5, 6; C. Egües Dubuc: None; N. Viveros-Pérez: None; M. Caeiro: None; A. Mayo-Juanatey: None; M. Retuerto Guerrero: None; M. Osorio-Sanjuan: None; L. Sala: None; R. Blanco: AbbVie/Abbott, 2, 5, 6, Bristol-Myers Squibb(BMS), 2, 6, Eli Lilly, 2, 6, Janssen, 2, 6, Merck/MSD, 2, 5, 6, Pfizer, 2, 6, Roche, 2, 5, 6.

To cite this abstract in AMA style:

Calvo-Río V, Sánchez Bilbao L, Secada-Gómez C, Hernández Velasco P, González-García C, Morales E, Galindo-Izquierdo M, Sandoval-Moreno S, Cortés-Hernández J, Egües Dubuc C, Viveros-Pérez N, Caeiro M, Mayo-Juanatey A, Retuerto Guerrero M, Osorio-Sanjuan M, Sala L, Blanco R. Kidney Transplantation In Lupus Nephritis. Multicenter Study Of 103 Patients [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/kidney-transplantation-in-lupus-nephritis-multicenter-study-of-103-patients/. Accessed .

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