Lupus最新文献

{"title":"A better self-efficacy is predictive of lower fatigue in systemic lupus erythematosus patients: Data from a Almenara Lupus Cohort.","authors":"Manuel F Ugarte-Gil, Rocío V Gamboa-Cárdenas, Victor Pimentel-Quiroz, Cristina Reategui-Sokolova, Claudia Elera-Fitzcarrald, Francisco Zevallos, Zoila Rodriguez-Bellido, Cesar Pastor-Asurza, Risto Perich-Campos, Graciela S Alarcón","doi":"10.1177/09612033251325320","DOIUrl":"10.1177/09612033251325320","url":null,"abstract":"<p><p><b>Objectives:</b> To determine the possible predictive value of self-efficacy on fatigue in SLE patients. <b>Methods:</b> SLE patients from a single-center prevalent cohort were included. Self-efficacy was ascertained with the five instruments of the Patient-Reported Outcomes Measurement Information System® (PROMIS®) Self-efficacy for Managing Chronic Conditions plus the PROMIS general self-efficacy. For PROMIS instruments, a score of 50 is the average for a clinical population (people with a chronic condition), the higher score, the greater self-efficacy. Fatigue was ascertained with the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F), the higher score, the lower fatigue. Generalized estimating equations were performed, using as outcome the FACIT-F in the subsequent visit, and the self-efficacy instrument in the previous visit; multivariable models were adjusted for possible confounders. All the confounders were measured in the same visit than the self-efficacy instrument. <b>Results:</b> A total of 209 patients and 563 visits were included. At baseline, FACIT-F was 33.0 (10.2), mean general self-efficacy was 47.2 (10.4), self-efficacy for managing emotions was 44.6 (8.0), for managing symptoms was 47.7 (8.2), for managing daily activities was 45.5 (7.5) for managing social interactions was 42.9 (7.9) and for managing medications and treatment was 43.9 (7.0). In the multivariable models a lower fatigue was predicted by self-efficacy for managing symptoms and managing activities. <b>Conclusion:</b> A better self-efficacy is predictive of a subsequent lower fatigue, even after adjustment for possible confounders. Strategies to improve self-efficacy in SLE patients should be encouraged.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"519-524"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating large language models as a supplementary patient information resource on antimalarial use in systemic lupus erythematosus.","authors":"Pamela Munguía-Realpozo, Claudia Mendoza-Pinto, Ivet Etchegaray-Morales, Edith Ramírez-Lara, Juan Carlos Solis-Poblano, Socorro Méndez-Martínez, Laura Serrano Vertiz, Jorge Ayón-Aguilar","doi":"10.1177/09612033251324501","DOIUrl":"10.1177/09612033251324501","url":null,"abstract":"<p><p>ObjectiveTo assess the accuracy, completeness, and reproducibility of Large Language Models (LLMs) (Copilot, GPT-3.5, and GPT-4) on antimalarial use in systemic lupus erythematosus (SLE).Materials and MethodsWe utilized 13 questions derived from patient surveys and common inquiries from the National Health Service. Two independent rheumatologists assessed responses from the LLMs using predefined Likert scales for accuracy, completeness, and reproducibility.ResultsThe GPT models and Copilot achieved high scores in accuracy. However, the completeness of outputs was rated at 38.5%, 55.9%, and 92.3% for Copilot, GPT-3.5, and GPT-4. When questions related to \"mechanism of action\" and \"lifestyle\", were analyzed for completeness (<i>n</i> = 8), ChatGPT-4 scored significantly higher (100%) compared to Copilot (37.5%). In contrast, questions related to \"side-effects\" (<i>n</i> = 5) scored higher for ChatGPT models than Copilot, and the differences were not statistically significant. All three LLMs demonstrated high reproducibility, with rates ranging from 84.6% to 92.3%.ConclusionsAdvanced LLMs like GPT -4 offer significant promise in enhancing patients' understanding of antimalarial therapy in SLE. Although chatbots' capability can potentially bridge the information gap patients face, the performance and limitations of such tools need further exploration to optimize their use in clinical settings.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"374-380"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real world use of belimumab in patients with lupus nephritis.","authors":"Luxme Nadarajah, Cameron Bonthrone, Angela Pakozdi, Debasish Pyne, Andrea Cove-Smith, Ravindra Rajakariar","doi":"10.1177/09612033251325297","DOIUrl":"10.1177/09612033251325297","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"435-436"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health journey of Nigerian patients with systemic lupus erythematosus.","authors":"Hakeem Babatunde Olaosebikan, Abubakar Yerima, Gbenga Joshua Odunlami, Courage Ukponmwan Uhunmwangho, Henry Madu Nwankwo, Musa Bello Kofar Na'isa, Mary Agun-Ebreme, Ibrahim Daiyabu, Ilo Azizat Bamisebi, Etseoghena Igebu, Henry Ekpenyong, Hassana Hindatu Aliyu, Olufemi Oladipo Adelowo","doi":"10.1177/09612033251324482","DOIUrl":"10.1177/09612033251324482","url":null,"abstract":"<p><p>BackgroundAlthough there is an increase in prevalence and incidence of lupus worldwide, the journey to diagnosis is unduly delayed. This delay is associated with worse outcomes. Sub-Saharan Africa has witnessed an increase in lupus diagnosis in recent decades with no specific data on the time to diagnosis of lupus.ObjectivesWe measured and documented lupus diagnostic delays, patients' experiences, and factors associated with delayed diagnosis and provided recommendations for early diagnosis.MethodsThis is a three-month cross-sectional study of 245 patients diagnosed with lupus who are members of a Nigerian lupus support group. Included participants fill out patients' administered questionnaire in a Google doc. The questionnaire captured all aspects of the study objectives. Four diagnostic journey intervals were defined. Delayed diagnosis was defined as a time interval from first symptoms to lupus diagnosis greater than or equal to 6 months.ResultsThe majority of participants were under 40 years of age (<i>n</i>-187, 76.3%) and predominantly female (<i>n</i>-226, 92.9%). About 53.9% of participants were diagnosed between 6 months and 2 years after their first symptoms, while 42% visited the first doctor within 6 months of symptom onset. Roughly half of the participants were referred to rheumatologists within 6 months of their visit to the last doctor, while 50.2% of the participants were diagnosed within 4 weeks of the rheumatologist's evaluation. Delayed diagnosis and delayed referral were documented in 80% and 66.9% of participants respectively. Low income (OR-7.4), internal organ manifestations (OR-4.5), and multiple doctors' visits (OR-11.6) were independently associated with delayed diagnosis.ConclusionsDiagnostic delay is observed in the majority of our patients. This delay is associated with multiple hospital visits, low income, and internal organ manifestations. There should be concerted efforts in SSA to improve the rheumatology workforce and incorporate non-specialists in clinical service delivery.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"425-434"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic lupus erythematosus with hypothermia and Wallenberg's syndrome as signs of brainstem encephalitis: A grand rounds case.","authors":"Reo Shiratani, Takayuki Shibahara, Mikio Shiba, Haruka Murao, Jeong Hoon Park, Tomomi Tada, Nachi Ishikawa, Jun Fujimoto, Junki Jinno, Makoto Tatsumi, Tomoki Yamada, Yoshiharu Higuchi, Shinji Higa","doi":"10.1177/09612033251324496","DOIUrl":"10.1177/09612033251324496","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is an autoimmune disease that causes inflammation and organ damage. However, brain-stem encephalitis is rare in patients with SLE. We report a rare case of a patient with incipient SLE who simultaneously presented with brainstem encephalitis and cardiomyopathy. An 18-year-old woman was admitted to our hospital with fever, polyarthralgia, and malar rash. Laboratory tests revealed leukopenia, thrombocytopenia, proteinuria, an elevated anti-double-stranded deoxyribonucleic acid antibody titer, and hypocomplementemia. She was diagnosed with SLE and treated with an intermediate dose of prednisolone. Her fever disappeared 2 days later, but high-grade fever reappeared, and a high dose of prednisolone was administered from the eighth day of hospitalization. On the tenth day of hospitalization, she developed a headache, hypothermia, dysphagia, respiratory failure, and myocarditis. Brain magnetic resonance imaging indicated brainstem encephalitis. Under ventilator management, the patient received intravenous methylprednisolone pulse therapy, cyclophosphamide, and plasma exchange. Her general condition improved, however, dysphagia and hoarseness persisted, and Wallenberg's syndrome was diagnosed. Our findings suggest that patients with SLE can present with Wallenberg's syndrome as a sign of brainstem encephalitis and that early aggressive immunotherapy can be effective in patients with brainstem encephalitis and cardiomyopathy associated with SLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"525-532"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and motivations to exercise participation among women with severe systemic lupus erythematosus who have recently undergone glucocorticoid pulse therapy: A qualitative analysis.","authors":"Juliana M Barboza, Gabriel P Esteves, Willian Jd Ribeiro, Vithor R Fickert, Andre S Franco, Luciana Parente Costa Seguro, Hamilton Roschel, Bruno Gualano, Eimear Dolan","doi":"10.1177/09612033251330116","DOIUrl":"10.1177/09612033251330116","url":null,"abstract":"<p><p>BackgroundPhysical activity is important in the management of systemic lupus erythematosus, yet available evidence indicates that inactivity and poor physical fitness are commonplace. Individuals with SLE, and particularly those whose condition severity warrants aggressive pharmacological treatment such as glucocorticoid pulse therapy, may face substantial barriers to exercise participation. A better understanding of these may be useful to develop targeted and effective exercise recommendations and strategies.PurposeTo explore motivations and barriers for exercise participation in a group of women with SLE who have recently undergone glucocorticoid pulse therapy.MethodsThis is a cross-sectional, exploratory study, whereby participants underwent individually administered semi-structured interviews related to personal motivations and barriers to exercise training. Self-reported well-being and quality of life were assessed using the Systemic Lupus Erythematosus Quality of Life (SLEQOL) and SF-36 questionnaires.ResultsTwenty-three women, with a high median level of disease activity (SLEDAI 8; IQR: 4-12) participated in the study. All participants reported wide-ranging health benefits as a motivation to exercise, but the majority did not exercise. They cited numerous health-related, personal and social barriers to exercise participation. SF-36 results indicated that the group experienced difficulties in participating in work and other regular daily activities.ConclusionAlthough the group recognized the health-related benefits of exercise, this knowledge was insufficient to encourage exercise participation. Exercise professionals must remain cognizant of the wide-ranging health-related, personal and social barriers that may exist for this group, and to consider these when formulating exercise recommendations.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"492-499"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of SARS-CoV-2 pre-delta/delta and omicron variants on clinical outcomes in a systemic lupus erythematosus cohort from Puerto Rico.","authors":"Lilliana Serrano-Arroyo, Ariana González-Meléndez, Rafael Ríos-Rivera, Valeria Rodríguez-González, Luis M Vilá","doi":"10.1177/09612033251325361","DOIUrl":"10.1177/09612033251325361","url":null,"abstract":"<p><p>ObjectiveTo examine the clinical outcomes of systemic lupus erythematosus (SLE) patients with COVID-19 during the Pre-Delta/Delta and Omicron periods.MethodsA retrospective study was conducted in a cohort of adult Puerto Ricans with SLE. Demographic parameters, SLE and COVID-19 manifestations, comorbidities, pharmacologic treatment, SLE exacerbations, hospitalizations, and mortality were determined. SARS CoV-2 infection was confirmed by polymerase chain reaction or antigen tests. Variables were compared between the Pre-delta/Delta and Omicron periods. Also, the proportion of COVID-19 cases and mortality of SLE patients was compared to the general population of Puerto Rico.ResultsOf the entire SLE cohort (<i>n</i> = 347), 169 patients (48.7%) had COVID-19. Twenty-two patients had COVID-19 during the Pre-delta/Delta period and 147 during the Omicron period. The proportion of COVID-19 cases in the SLE cohort was significantly higher when compared to the adult general population of Puerto Rico (25.7%), but no difference in mortality was found. Overall, the clinical outcomes of COVID-19 in the SLE cohort were favorable, with low rates of lupus flares (3.0%), hospitalizations (3.6%), and mortality (0.6%). Patients with COVID-19 during the Pre-delta/Delta period were more likely to have oral ulcers, anti-Smith antibodies, and chronic kidney disease, whereas those during the Omicron period were more likely to have COVID-19 symptoms (rhinorrhea, sore throat, and cough).ConclusionIn summary, is this group of Puerto Ricans with SLE, a high proportion had COVID-19, but disease exacerbation, hospitalization, and mortality rates were low. Few clinical differences were noted in SLE patients when comparing the Pre-delta/Delta and Omicron periods.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"415-424"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of low-grade proteinuria with changes of lupus nephritis in kidney biopsy in SLE patients.","authors":"Homa Timlin, Abbal Koirala, Matthew Gross, Duvuru Geetha, Ihab Kamel, Mohamed G Atta","doi":"10.1177/09612033251321655","DOIUrl":"10.1177/09612033251321655","url":null,"abstract":"<p><p>BackgroundA kidney biopsy is essential for definitive histopathological diagnosis in lupus nephritis, informing therapeutic strategies. Current guidelines (ACR and EULAR/ERA-EDTA) do not include a kidney biopsy for patients with isolated proteinuria of less than 500 mg/g. We explored the histopathologic findings in patients with SLE with proteinuria ≤500 mg/g.MethodsWe conducted a retrospective review of 27 biopsies of lupus patients with proteinuria ≤500 mg/g who underwent a kidney biopsy at Johns Hopkins. Clinical and laboratory data were obtained from a review of the medical records. The study was approved by the Office of Human Subjects Research and Institutional Review Board.ResultsMost individuals were females (93%) and African American (56%), with a mean age of 42.1 (12.4) years at the time of biopsy. Twelve individuals had no prior history of lupus nephritis. The average creatinine at the biopsy was 1.05 mg/dl, and UPCR was 0.27 grams/gram. Most patients (100%) were on hydroxychloroquine, 41% were on prednisone, and 33% were on mycophenolate mofetil. Kidney biopsies were most commonly performed based on extra-renal disease activity, new-onset or worsening proteinuria (88.9%) and worsening dsdNA levels (55.6%). At the time of biopsy, 55.6% of patients presented with extrarenal lupus, most commonly arthritis or arthralgias and mucosal ulcers. Of the 27 patients, 23 patients had evidence of lupus nephritis (85.1%), including class III (33%), V (30%), III/V (7%), class II (4%) and class I (11%). Nine patients had a UPCR of 200 mg/g or lower. Among these patients, 22% did not show signs of lupus nephritis in the kidney biopsy, 44% had class V LN, and 11% had class I and III LN. Kidney biopsy was well tolerated, with the majority (93%) not developing post-biopsy complications.ConclusionsWe identified patients with proteinuria ≤500 mg/g who had lupus nephritis, with the majority ranging from Class III to V with only one class II. This study supports that normal or low UPCR <500 mg/g lacks the sensitivity to detect early lupus nephritis. Better biomarkers for the cutoff of biopsy are needed to improve kidney outcomes and trial design.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"331-336"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long COVID in patients with systemic lupus erythematosus: A case-control study.","authors":"Chris Ching Lam Cheung, Chi Chiu Mok","doi":"10.1177/09612033251326987","DOIUrl":"10.1177/09612033251326987","url":null,"abstract":"<p><p>BackgroundLong COVID was defined by the WHO as continuation or development of new symptoms 3 months after the initial SARS-CoV2 infection, with these symptoms lasting for ≥2 months without alternative explanations.ObjectivesTo compare the incidence of long COVID in patients with SLE with matched controls after a SARS-CoV2 infection.MethodsConsecutive patients (≥18 years) who fulfilled the ACR or SLICC criteria for SLE between July to November 2023 were recruited. Those with SARS-CoV2 infection (positive rapid antigen test [RAT] or PCR) were identified by a self-reported questionnaire, which also captured the duration and severity of a number of pre-defined symptoms of long COVID. An equal number of healthy subjects, matched for gender and age, who had SARS-CoV2 infection in the same period were recruited for the same survey. The incidence and presentation of long COVID was compared between patients and controls, and risk factors for long COVID in SLE patients were studied.ResultsA total of 211 SLE patients (97.6% women, age 44.2 ± 11.9 years) and 211 healthy controls (97.6% women, age 44.2 ± 11.9 years) were studied. In all patients, the most common long COVID symptoms were fatigue (30.1%), worsening of memory (29.1%), difficulty to concentrate (26.3%), cough (23.2%) and insomnia (18.9%). Compared with controls, the incidence of long COVID was significantly higher in SLE patients (54.5% vs 34.6%; OR 2.27 [1.53-3.35]). Symptoms of worsening of memory (OR 2.77 [1.78-4.31]), chest pain (OR 4.18 [1.16-15.0]), palpitation (OR 3.43 [1.58-7.47]) and arthralgia (OR 2.67 [1.29-5.53]) were significantly more common in SLE patients than controls. However, no clinical and serological factors were significantly associated with the occurrence of long COVID in SLE patients except the ever use of hydroxychloroquine (OR 2.03 [1.04-3.96]).ConclusionsLong COVID is more common in SLE patients than matched controls after a SARS-CoV2 infection. The development of long COVID symptoms in SLE is largely unpredictable.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"452-459"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of the modified National Institute of health activity and chronicity scoring system in predicting end-stage kidney disease in Latin American lupus nephritis patients.","authors":"Joaquín Roberto Rodelo-Ceballos, Lina Aguirre, Luis Alonso González","doi":"10.1177/09612033251325315","DOIUrl":"10.1177/09612033251325315","url":null,"abstract":"<p><p>ObjectiveTo assess the effectiveness of the modified National Institute of Health (mNIH) activity and chronicity scoring system in predicting the progression to end-stage kidney disease (ESKD) in Latin American lupus nephritis (LN) patients.MethodsWe retrospectively analyzed 412 patients with biopsy-proven LN. ESKD was defined as an estimated glomerular filtration rate (eGFR) < 15 mL/min/1.73 m² for ≥3 months, dialysis for >3 months, or kidney transplant. Univariable and multivariable Cox proportional hazards regression analyses were performed to evaluate the predictive value of the mNIH activity and chronicity indices for ESKD.Results84 patients (20.4%) progressed to ESKD at a median of 3.0 months after biopsy. The mNIH activity and chronicity indices were significantly higher in patients who progressed to ESKD compared to those who did not [7 (5-10) versus 4 (1-7), <i>p</i> < .001; and 3 (1-5) versus 0 (0-2), <i>p</i> < .001, respectively]. Multivariable Cox regression analysis revealed that the mNIH activity index (HR 1.17, 95% CI 1.05-1.29), and the mNIH chronicity index (HR 1.21, 95% CI 1.05-1.40) were independently associated with a higher risk of ESKD, adjusting for age, sex, ethnicity, and eGFR. Furthermore, fibrinoid necrosis (HR 4.09, 95% CI 1.54-10.86) and fibrous crescents (HR 2.36; 95% CI 1.06-5.27), components of the activity and chronicity indices, respectively, were also associated with a shorter time to ESKD.ConclusionsIn Latin American LN patients, the mNIH activity and chronicity indices are associated with an increased risk of ESKD. Among the components of these indices, shorter time to ESKD was mainly driven by fibrinoid necrosis and fibrous crescents.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"381-394"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}