Abstract: FR-PO0830
Beyond Clinical Remission: Insights from Protocol Repeat Kidney Biopsies in a Mexican Cohort
Session Information
- Glomerular Diseases: Practice and New Concepts Shaping Modern Care
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Barrientos Feria, Sarai Ruth, Hospital Juarez de Mexico, Mexico City, CDMX, Mexico
- Morales, Brenda, Hospital Juarez de Mexico, Mexico City, CDMX, Mexico
- Vasquez, Enzo, Hospital Juarez de Mexico, Mexico City, CDMX, Mexico
- Soto, Virgilia, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Méx., Mexico
- Garcia-Flores, Octavio Rene, Hospital Juarez de Mexico, Mexico City, CDMX, Mexico
- Zavala, Maria Fernanda, Hospital Juarez de Mexico, Mexico City, CDMX, Mexico
Background
Kidney biopsy is the gold standard for lupus nephritis (LN) diagnosis; the utility of repeat biopsies remains debated. This study evaluates a single-center experience with protocol repeat biopsies.
Methods
Prospective cohort study at a Mexican reference center included 25 LN patients with protocol-repeat biopsies. Remission defined according to KDIGO. Baseline and 12-month follow-up findings were compared using Wilcoxon signed-rank test. Clinical and histological response associations were assessed via Fisher’s exact test, and Spearman’s correlation identified factors associated with histological changes.
Results
Of 25 patients, 92% were female; with median age 34 years (IQR:25–42). Baseline median proteinuria was 2.1 g/24h (IQR 1.5–2.8) and the activity-index (AI) was 11.0 (IQR 8–15). Cyclophosphamide was the common induction therapy (80%). At 12 months, 40% achieved complete-remission(CR) and 52% partial-remission(PR). The median interval between biopsies was 11 months (IQR 9–12). Post-treatment, AI significantly decreased (11 vs 2, p<0.001), with no changes in chronicity or interstitial infiltration. A clinicopathological dissociation was identified, as clinical response did not associate with histological response (AI≤2; p=0.695). 60% of patients in CR exhibited persistent silent activity, whereas 62% in PR achieved histological response. AI reduction correlated positively with baseline AI (ρ=0.755, p<0.001). Baseline proteinuria and induction regimens did not influence the magnitude of histological improvement.
Conclusion
Clinical response criteria in LN are poor predictors of histological resolution. Follow-up biopsies could represent a valuable tool for remission assessment and long-term management decisions.
Figure 1. Histological Activity changes from baseline to 12 months (A) and Clinicopathological dissociation between clinical response and histological response (B).
Funding
- Government Support – Non-U.S.