Abstract: SA-PO0803
Long-Term Follow-Up of a Pure Class V Lupus Nephritis Cohort at Mayo Clinic
Session Information
- Glomerular Research: Design, Registries, Surveys, and Epidemiology
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Berti, Gian Marco, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Cara, Anila, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Vargas-Brochero, Maria J., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Russo, Ilario, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Zand, Ladan, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Sethi, Sanjeev, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Fervenza, Fernando C., Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background
Data on long-term outcomes in pure class V Lupus Nephritis (LN) are limited since most studies include mixed classes.
Methods
Retrospective cohort study on biopsy-proven LN class V (2000-2024). Laboratory data were collected at baseline and every 6 months. We used a linear regression mixed model to estimate 5-years eGFR slopes (primary outcome).
Results
Of 55 patients, 72% were female, 41% white and mean age 39.2(13.5) years. Median follow-up of 83 months. Baseline characteristics, sorted by serological status, are shown in Table 1. Compared to the anti- dsDNA+ group, anti-dsDNA− patients had higher median proteinuria and lower serum albumin. In contrast, anti-dsDNA+ cohort exhibited significantly more frequently hypocomplementemia. Interstitial fibrosis and tubular atrophy (IFTA) were more pronounced in the anti-dsDNA+ group. In anti-dsDNA negative patients, electron microscopy showed predominantly subepithelial deposits with fewer intramembranous ones. As shown in Table 2, a significant negative eGFR slope, reflecting kidney function decline, was observed at 60 months of follow-up with no difference between anti-dsDNA groups. Higher glomerular sclerosis (GS) and interstitial fibrosis (IF) are significantly associated with lower eGFR values. Mycophenolate mofetil (MMF) use was associated with improved eGFR over time.
Conclusion
In our cohort, serological status was associated with clinical and histological differences. The strongest predictors of eGFR decline, regardless of serologic profile, were GS and IF. MMF improved significantly long-term renal function.