ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 1463

Short- and Long-Term Progression of Kidney Involvement in Systemic Lupus Erythematosus Patients with Low-Grade Proteinuria

Shudan Wang1, Allan Spielman2, Mindy Ginsberg2, Michelle Petri3, Brad Rovin4, Jill Buyon5 and Anna Broder6, 1Montefiore Medical Center / Albert Einstein College of Medicine, New York, NY, 2Albert Einstein College of Medicine, Bronx, NY, 3Johns Hopkins University School of Medicine, Division of Rheumatology, Baltimore, MD, 4The Ohio State University, Columbus, OH, 5NYU Grossman School of Medicine, New York, NY, 6Hackensack University Medical Center, Hackensack, NJ

Meeting: ACR Convergence 2022

Keywords: Lupus nephritis

  • Tweet
  • Email
  • Print
Session Information

Date: Sunday, November 13, 2022

Title: SLE – Diagnosis, Manifestations, and Outcomes Poster II: Manifestations

Session Type: Poster Session C

Session Time: 1:00PM-3:00PM

Background/Purpose: Lupus nephritis remains a common cause of morbidity and mortality in systemic lupus erythematosus (SLE). Current guidelines recommend performing a kidney biopsy at urine protein-to-creatinine ratio (UPCR) of ≥0.5. However, cross-sectional studies reported a high prevalence of active histological lupus nephritis lesions, and even chronic scarring, in patients with low-grade proteinuria This study was initiated to assess disease progression in SLE patients with low-grade proteinuria to identify risk factors for progression to overt proteinuria suggestive of clinical lupus nephritis.

Methods: SLE patients with incident UPCR ≥ 0.2 and < 0.5 (UPCR≥ 0.2 &< 0.5) without known lupus nephritis were identified from the Einstein Rheumatic Disease Registry. Patients who developed a random UPCR of ≥ 0.5 with or without biopsy during the follow-up period were defined as “progressors”. Patients who progressed to UPCR>0.5 within two years from developing UPCR≥ 0.2 &< 0.5 were defined as “fast progressors”, a subgroup expected to benefit most from early biopsies and therapeutic interventions.

Results: Among 151 eligible SLE patients with low-grade proteinuria at study entry, 76 (50%) progressed to UPCR≥0.5 of which 44 underwent a clinically indicated biopsy (Figure 1). Sixty-one percent of progressors developed UPCR≥0.5 within 2 years of follow-up. Of the 20 biopsies performed in the first 2 years, 16 had active, treatable lupus nephritis. Low complement and shorter SLE duration at low-grade proteinuria onset most consistently associated with progression to overt proteinuria. Other associated factors included hypertension, diabetes mellitus, younger age and the presence of hematuria.

Conclusion: In this longitudinal cohort, over half of SLE patients with new-onset low-grade proteinuria without a prior diagnosis of lupus nephritis progressed to overt proteinuria and 11 percent had a biopsy consistent with treatable lupus nephritis within 2 years, supporting the role of early biopsy to diagnose and treat lupus nephritis. The data from this study lay the groundwork for future studies of underlying molecular pathways in progression of early lupus nephritis by identifying at risk populations. Early lupus nephritis diagnosis and effective intervention reduce adverse, long-term kidney complications. The ability to prevent injury should result in less overall exposure to toxic medications and better preservation of kidney mass. There is currently a dearth of reliable clinical markers to predict which SLE patients with low grade proteinuria should be biopsied. Understanding the molecular mechanisms activated in the kidney at the earliest stage in high-risk populations will be critical for developing biomarkers of early disease.

Supporting image 1

Figure 1


Disclosures: S. Wang, None; A. Spielman, None; M. Ginsberg, None; M. Petri, Exagen, AstraZeneca, Alexion, Amgen, AnaptysBio, Argenx, Aurinia, Biogen, Caribou Biosciences, CVS Health, EMD Serono, Eli Lilly, Emergent Biosolutions, GlaxoSmithKline (GSK), IQVIA, Janssen, Kira Pharmaceuticals, MedShr, Sanofi, SinoMab, Thermofisher, BPR Scientific Advisory Committee; B. Rovin, AstraZeneca, Aurinia, Biogen, Genetech, Janssen, Lupus Foundation of America, GlaxoSmithKlein(GSK); J. Buyon, None; A. Broder, None.

To cite this abstract in AMA style:

Wang S, Spielman A, Ginsberg M, Petri M, Rovin B, Buyon J, Broder A. Short- and Long-Term Progression of Kidney Involvement in Systemic Lupus Erythematosus Patients with Low-Grade Proteinuria [abstract]. Arthritis Rheumatol. 2022; 74 (suppl 9). https://acrabstracts.org/abstract/short-and-long-term-progression-of-kidney-involvement-in-systemic-lupus-erythematosus-patients-with-low-grade-proteinuria/. Accessed .
  • Tweet
  • Email
  • Print

« Back to ACR Convergence 2022

ACR Meeting Abstracts - https://acrabstracts.org/abstract/short-and-long-term-progression-of-kidney-involvement-in-systemic-lupus-erythematosus-patients-with-low-grade-proteinuria/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology