{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T04:24:27Z","timestamp":1786940667943,"version":"build-2736575974"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005187","name":"University of Athens","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005187","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Rheumatol Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    EULAR recommends kidney biopsy in systemic lupus erythematosus (SLE) patients with glomerular hematuria, whereas both ACR and KDIGO require the presence of proteinuria and\/or impaired kidney function. We explored the value of hematuria for the diagnosis of new-onset lupus nephritis (LN). Cross-sectional study of SLE patients who underwent diagnostic kidney biopsy in two independent centers. Clinically significant LN was defined as ISN\/RPS class III, IV, V, or mixed III\/IV\u2009+\u2009V. Presentation patterns were categorized by glomerular hematuria, proteinuria, and impaired kidney function. Among patients with glomerular hematuria, regression models identified factors associated with clinically significant LN, and a nomogram was constructed. Of 227 biopsies, 181 (79.7%) showed clinically significant LN. Isolated glomerular hematuria was evident in 11 patients, of whom 9 revealed non-LN pathology; the two LN cases (class II and III) both demonstrated concurrent SLE serologic activity. Among patients with glomerular hematuria (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009137), independent factors associated with clinically significant LN included anti-dsDNA positivity (OR 12.00, 95% CI 3.36\u201351.40), higher non-renal SLEDAI score (OR 1.20 per point, 95% CI 1.02\u20131.46), higher proteinuria (OR 3.77 per 1\u00a0g\/d, 95% CI 2.00\u20139.03), and younger age (OR 0.96 per year, 95% CI 0.91\u20131.00). The combined presence of these factors yielded a predicted probability of 97% (95% CI 90\u201399%) of clinically significant LN, whereas their absence was associated with a probability of only 6% (95% CI 1\u201323%). When considering the need for kidney biopsy in patients with lupus, hematuria should be evaluated in the context of overall disease activity; extra-renal and serologic activity substantially increase the likelihood of clinically significant LN.\n                  <\/jats:p>","DOI":"10.1007\/s00296-026-06264-4","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T08:20:04Z","timestamp":1786090804000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with clinically significant nephritis in systemic lupus erythematosus patients who present with glomerular hematuria: a cross-sectional study"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0143-6404","authenticated-orcid":false,"given":"Konstantinos","family":"Drougkas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9628-4305","authenticated-orcid":false,"given":"Eda","family":"Otman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8575-5183","authenticated-orcid":false,"given":"Spyridon","family":"Katechis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1296-0693","authenticated-orcid":false,"given":"Maria","family":"Pappa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozge","family":"Yogurtcu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5423-5847","authenticated-orcid":false,"given":"Sofia","family":"Flouda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8994-5267","authenticated-orcid":false,"given":"Petros","family":"Nikolopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1643-8923","authenticated-orcid":false,"given":"Sophia","family":"Lionaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5647-6505","authenticated-orcid":false,"given":"Aggelos","family":"Banos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3228-0433","authenticated-orcid":false,"given":"George","family":"Liapis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5299-1406","authenticated-orcid":false,"given":"George","family":"Bertsias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9812-4671","authenticated-orcid":false,"given":"Dimitrios T.","family":"Boumpas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2696-031X","authenticated-orcid":false,"given":"Antonis","family":"Fanouriakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"6264_CR1","doi-asserted-by":"publisher","first-page":"2110","DOI":"10.1056\/NEJMra1100359","volume":"365","author":"GC Tsokos","year":"2011","unstructured":"Tsokos GC (2011) Systemic Lupus Erythematosus. 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As the study relied on routinely collected and de-identified data, informed consent from patients was not required.","order":2,"name":"Ethics","label":"<b>Ethical approval<\/b>","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This work was presented during the 5th European Lupus Meeting in Lisbon, Portugal, March 04\u201307, 2026 (Drougkas K, Otman E, Katechis S, Pappa M, Yogurtcu O, Flouda S, et al. PT2:04\u2005Glomerular hematuria and its association with kidney pathology in systemic lupus erythematosus: a matter of context. Lupus Science & Medicine. 2026;13:.\n                      \n                      ).","order":3,"name":"Ethics","label":"Congress abstract publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Open Access Funding for this manuscript is covered by an agreement between the National and Kapodistrian University of Athens and Springer Nature, via HEAL-Link.","order":4,"name":"Ethics","label":"Open access funding","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"233"}}