{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:59:07Z","timestamp":1789153147722,"version":"build-2803163510"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Nephrol"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to determine the clinical significance of renal vascular lesions (RVLs) in childhood-onset lupus nephritis (cLN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed all children with biopsy-proven cLN between 2004\u20132020 to evaluate the prevalence of RVLs on kidney biopsy and its associated factors and long-term outcomes. The composite kidney outcome was defined as advanced chronic kidney disease (CKD) stage 3\u20135, kidney failure and death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      107 biopsies from 84 Chinese patients were analysed. RVLs were observed in 19 patients (22.6%), including non-inflammatory necrotizing vasculopathy (NNV,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), thrombotic microangiopathy (TMA,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094), arterial sclerosis (AS,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), concurrent NNV with AS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094), concurrent NNV with TMA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091) and concurrent true renal vasculitis with AS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091).\n                    <\/jats:p>\n                    <jats:p>\n                      The presence of RVLs was associated with lower estimated glomerular filtration rate (eGFR) (66.9\u2009\u00b1\u200940.3 vs. 95.6\u2009\u00b1\u200939.4\u00a0ml\/min\/1.73m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), haemoglobin level (9.1\u2009\u00b1\u20091.9 vs. 10.4\u2009\u00b1\u20091.9\u00a0g\/dL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008) and platelet count (150.1\u2009\u00b1\u200996.4 vs. 217.2\u2009\u00b1\u2009104.8\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). LN classes and activity\/chronicity indices were similar.\n                    <\/jats:p>\n                    <jats:p>\n                      Patients with RVLs had poorer composite kidney outcomes, though not reaching statistical significance (log-rank test,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06). The presence of NNV was associated with inferior survival free from composite kidney outcome (log-rank test,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0018), compared to other forms of RVLs and those without RVLs. Univariate analysis revealed NNV (HR 7.08, 95% CI 1.67\u201330.03) was predictive of composite kidney outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RVLs are present in one-fifth of cLN patients and are associated with severe presentation. NNV is associated with worse long-term kidney outcome. Routine evaluation of RVLs is warranted and should be incorporated into future classification criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                    <jats:p>A higher resolution version of the Graphical abstract is available as Supplementary information<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00467-024-06498-z","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T10:02:48Z","timestamp":1725876168000},"page":"131-141","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Renal vascular lesions in childhood-onset lupus nephritis"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9744-4975","authenticated-orcid":false,"given":"Kyle Ying-kit","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene Yu-hin","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuen-fun","family":"Mak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-chun","family":"To","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sze-wa","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona Fung-yee","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsz-wai","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pak-chiu","family":"Tong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai-ming","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desmond Yat-hin","family":"Yap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison Lap-tak","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,9]]},"reference":[{"key":"6498_CR1","doi-asserted-by":"publisher","first-page":"1414","DOI":"10.1177\/0961203310374339","volume":"19","author":"JL Huang","year":"2010","unstructured":"Huang JL, Yeh KW, Yao TC et al (2010) Pediatric lupus in Asia. 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