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Abstract: SA-PO683

Is Lupus Podocytopathy Always a Benign Glomerulopathy?

Session Information

Category: Glomerular Diseases

  • 1303 Glomerular Diseases: Clinical‚ Outcomes‚ and Trials


  • Dias, Cristiane B., Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Jorge, Lectícia, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Yu, Luis, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Woronik, Viktoria, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil

The aim of the study is to evaluate the clinical and histological characteristics, as well as evolution of patients with Lupus Podocytopathy (LP). LP is defined as patients with Systemic Lupus Erythematosus (SLE) and nephrotic syndrome whose diagnostic renal biopsy showed light microscopy with normal glomeruli (MCD) or focal segmental glomerulosclerosis (FSGS) or mesangial proliferation (MP), in addition to immunofluorescence with the absence of sub-epithelial or sub-endothelial deposits. For patients with a renal biopsy compatible with FSGS, the nephrotic presentation was not required as long as there was no chronicity on the renal biopsy.


This is a one Center retrospective study with LP patients submitted to renal biopsies from 1994 to 2017. Patients are highly responsive to corticosteroids but relapses are very common thus the impact of long-terms outcomes is unclear in literature.


During the study period, 31 patients met the criteria for LP and had a median age of 32 (28-40) years at the time of renal biopsy, median proteinuria of 4.9 (3.7-8.27) g/day and serum albumin of 2.18 (1.57-2.65) g/dl. Only two patients did not have nephrotic syndrome at the time of renal biopsy, in addition, 42% had CKDEPI <60 ml/min/1.73m2 and 25.8% had serum low C3 complement level. The time between the diagnosis of SLE and LP was 10 (2-33) months in 28 patients, whereas in three the renal diagnosis occurred before SLE. Histological diagnosis comprised 22 FSGS, 7 MCD and 2 MP. On follow-up owing to clinical criteria of progression and/or persistent proteinuria, ten patients underwent renal rebiopsy, highlighting that 5 patients transitioned to other histological class (3 Lupus Nephritis class IV originally one FSGS and two MP while 2 MP were originally MCD), others 5 patients remained as originally (4 FSGS with increased chronicity and 1 MCD). The median of follow-up time was 84 (53-120) months, being that two patients were lost to follow-up, while five patients (17%) had CKDEPI below 60 ml/min/1.73m2 and one was on dialysis.


LP has a variable course with transition to more severe histological classe of Lupus Nephritis (class IV in three patients out of 31) and evolution to chronic kidney disease in approximately 20% of patients.