ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO877

Characterization of Lupus Nephritis in a Predominantly Hispanic Population in the Western United States

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Nguyen, Jim, Keck School of Medicine of USC, Los Angeles, California, United States
  • Petrosyan, Nina, Keck School of Medicine of USC, Rolling Hills, California, United States
  • Stone, Gregory, Keck School of Medicine of USC, Rolling Hills, California, United States
  • Bedrossian, Nora, Keck School of Medicine of USC, Rolling Hills, California, United States
  • Mert, Melissa, University of Southern California, Los Angeles, California, United States
  • Shan, Hui Yi, Keck School of Medicine of USC, Los Angeles, California, United States
Background

Lupus Nephritis (LN) is a serious complication of systemic lupus erythematous (SLE). Both genetic and environmental factors play a role in disease manifestation and outcomes. Our study aims to characterize LN and its treatment in a predominantly Hispanic population residing in the Western US.

Methods

A retrospective chart review was conducted on all native kidney biopsies performed at Los Angeles County + USC Medical Center between 2008-2018. 124 patients with biopsy proven LN were identified.

Results

Among the total 124 patients, median age of diagnosis was 32 (26-42.5) years and the majority were female (87.8%) and self-reported as Hispanic (72.9%). The median serum creatinine and urine protein to creatinine ratio at baseline were 0.98 (0.71-1.92) mg/dl and 3.89 (1.47-6.32) mg/g, respectively. 72.6% had biopsies compatible with proliferative LN. Degree of tubular atrophy was significantly associated with remission status at 1-year (p=0.004). Subgroup analysis demonstrated better 1-year post induction partial (PR) and complete remission (CR) rates in patients who received mycophenolate (MMF) and steroid (29.7% PR, 51.4% CR) as compared to cyclophosphamide (CYC) and steroid (18.8% PR, 40.6% CR). Higher rate of relapse was observed in patients who received MMF and steroid compared to CYC and steroid (24.3% vs. 9.4%, respectively). A lower percentage of patients on MMF and steroid developed ESRD compared to patients treated with CYC and steroid (2.7% vs. 18.8%). A significantly higher proportion of patients who were not on hydroxychloroquine were diagnosed with ESRD compared with patients who were taking hydroxychloroquine (22.5% vs 6.5%, p=0.03).

Conclusion

Our study showed that this Hispanic cohort residing in the Western US presented early, with mildly elevated serum creatinine, minimal to no tubular atrophy, and primarily with proliferative LN. Of these treated patients, although it did not reach statistical significance, a noticeable trend was observed in achieving better remission rates at 1-year endpoint with MMF and steroid as induction therapy compared to CYC and steroid. Additionally, the use of hydroxychloroquine in this cohort is significantly associated with lower ESRD rate.