Abstract: TH-PO0765
Lupus Nephritis in Japan: Comparison of Initial and Repeat Biopsies Using the Japan Renal Biopsy Registry (J-RBR)
Session Information
- Glomerular Histopathology: Evolving Insights
November 06, 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
- Ikeuchi, Hidekazu, Department of Nephrology and Rheumatology, Gunma University, Maebashi, Japan
- Ozeki, Takaya, Department of Nephrology, Nagoya University, Nagoya, Japan
- Maruyama, Shoichi, Department of Nephrology, Nagoya University, Nagoya, Japan
- Tsuboi, Naotake, Department of Nephrology, Fujita Health University, Toyoake, Japan
- Tsuji, Takahiro, Department of Pathology, Sapporo City General Hospital, Sapporo, Japan
- Sugiyama, Hitoshi, Kawasaki Medical School General Medical Center, Okayama, Japan
- Hiromura, Keiju, Department of Nephrology and Rheumatology, Gunma University, Maebashi, Japan
Background
Lupus nephritis (LN) exhibits diverse histopathological features and repeat renal biopsies can reveal changes in histological classification over time. In this study, we compared initial and repeat biopsies of LN registered in the J-RBR.
Methods
We analyzed 682 patients of initial biopsies, and 128 patients of repeat biopsies registered in the J-RBR between 2018 and 2021.
Results
Clinical data at the time of biopsy are presented in Table 1. The urinary RBC score and eGFR were significantly higher at the time of the initial biopsy, whereas serum albumin levels and the proportion of patients receiving antihypertensive medications were significantly higher at repeat biopsy. Regarding renal histology, Class II was significantly less frequent and Class V significantly more frequent at repeat biopsy. Among Class III/IV cases, the frequency of pure Class IV decreased, while the mixed type (Class III/IV + V) significantly increased. In the J-RBR system, activity is classified according to the ISN/RPS 2003 system as active lesions (A), active/chronic lesions (A/C), and chronic lesions (C). In Class III/IV, repeat biopsies showed a significant decrease in (A) and a significant increase in (A/C) and (C).
Conclusion
Compared to initial biopsies, repeat biopsies in LN showed reduced hematuria and impaired renal function, along with an increased prevalence of membranous and chronic lesions.