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Kidney Week

Abstract: FR-PO882

Proteinuric Lupus-Related Kidney Disease: A Comparative Study of Pure Class V Lupus Nephritis vs. Lupus Podocytopathy

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Parikh, Nirav, Emory University School of Medicine, Atlanta, Georgia, United States
  • Pai, Rima N., Emory University School of Medicine, Atlanta, Georgia, United States
  • Alqudsi, Muhannad, Emory University School of Medicine, Atlanta, Georgia, United States
  • Cobb, Jason, Emory University School of Medicine, Atlanta, Georgia, United States
Background

Lupus-related kidney disease research has focused on proliferative forms of lupus nephritis, and membranous (MLN) lupus nephritis is less studied. A newer clinical entity associated primarily with proteinuria is lupus podocytopathy (LP) which is minimal change disease (MCD) or focal segmental glomerulosclerosis (FSGS) in patients with lupus without proliferative forms of lupus nephritis. The prognosis of patients with primarily proteinuric lupus-related kidney disease (pure class V lupus nephritis and lupus podocytopathy) isn’t well studied and especially in a predominantly African-American patient population. This is the first comparative study of outcomes between pure class V lupus nephritis and lupus podocytopathy.

Methods

Retrospective chart review from single academic medical system with statistical analysis using single tail t-test.

Results

Average age 34 years (MLN) and 35 years (LP). The initial serum albumin (sAlb) 2.6 g/dL (MLN) vs. 2.01 g/dL (LP) p<.01, initial serum creatinine (sCr) 1.19 mg/dL (MLN) vs. 3.01 mg/dL (LP) p<.005, and initial urine protein-creatinine ratio (UPC) 4.23 g/g (MLN) vs. 5.73 g/g (LP) p<.09. Mean follow-up 3.3 years (MLN) vs. 5 years (LP), p <.05. Final sAlb 3.4 g/dL (MLN) vs. 3.35 g/dL (LP) p<.41, final sCr 1.16 mg/dL (MLN) vs. 1.20 mg/dL (LP) p<.44, final UPC 1.11 g/g (MLN) vs. 1.11 g/g (LP) p<0.50.

Conclusion

Both groups at initial presentation with similar age and nephrotic range proteinuria but statistically significant differences with a lower sAlb and higher sCr in lupus podocytopathy. Prognosis similar with no statistically significant differences at final presentation in final sAlb, sCr, or UPC despite lupus podocytopathy having a more severe initial presentation. A strength of this study is length of follow-up with 3.3-5 years in our patient population. Both groups at final presentation with acceptable renal function with final sCr of 1.2 mg/dL and non-nephrotic range proteinuria.