Kidney Week

Abstract: SA-PO0820

Value of Repeat Biopsy in Patients with Lupus Nephritis and No Remission Compared with Those Achieving Complete or Partial Remission

Session Information

• Glomerular Diseases: Management, Evolving Strategies, and Practice-Changing Advances
  October 24, 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

• Siddiq, Summra, Epsom and Saint Helier University Hospitals NHS Trust, Carshalton, England, United Kingdom

Summra Siddiq, RD

• Jewel, Nasir Hossain, Epsom and Saint Helier University Hospitals NHS Trust, Carshalton, England, United Kingdom

Nasir Hossain Jewel, DrMed, MBBS

• Awadallah, Omar Mahmoud, Epsom and Saint Helier University Hospitals NHS Trust, Carshalton, England, United Kingdom

Omar Mahmoud Awadallah, MD

• Amayreh, Maan, Epsom and Saint Helier University Hospitals NHS Trust, Carshalton, England, United Kingdom

Maan Amayreh, MD

• Sood, Bhrigu Raj, Epsom and Saint Helier University Hospitals NHS Trust, Carshalton, England, United Kingdom

Bhrigu Raj Sood, MBBS

• Makanjuola, David, Epsom and Saint Helier University Hospitals NHS Trust, Carshalton, England, United Kingdom

David Makanjuola, MD

• Harris, Fiona E., Epsom and Saint Helier University Hospitals NHS Trust, Carshalton, England, United Kingdom

Fiona E. Harris

Background

Lupus nephritis (LN) is a major cause of kidney disease, morbidity, and mortality. Despite advances in therapy, relapse is common after treatment, particularly in Class III/IV and mixed proliferative–membranous LN. Inflammatory injury causes fibrosis, declining renal function, and increased cardiovascular risk. Our aim was to see whether in patients with LN who were biopsied either for failure to remit, because of relapse, the original class of nephritis had changed, and what the effect of the escalation of treatment was after the second biopsy.

Methods

Data from medical records were reviewed, including demographic characteristics and laboratory parameters.

Results

We reviewed the data of 26 patients with biopsy proven LN. They were divided into 2 groups; those with complete or partial remission (PR) - (Group A, n =16) and those with no remission (Group B, n=8).
After escalating treatment, 50% (n=4) in group B achieved partial remission. In group A, 72.2% were in PR and 27.7% were in CR, and following treatment after relapse, 38.9% achieved CR and 61.1% had PR.
Table 1 shows the findings on repeat biopsy. The class of LN switched in 50% of those in group A, and it was 37.5% in group B.

Conclusion

There was a trend towards a greater change in the class of LN in patients who originally go into remission and then relapse, as compared with patients who didn’t respond to initial treatment. This highlights the utility of repeat biopsies in patients who relapse, as the class switch might need not just escalation of the current treatment, but a complete change in the agents used.