{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T15:34:37Z","timestamp":1773070477138,"version":"3.50.1"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"ALF funding from Region Stockholm"},{"name":"Karolinska Institutet Foundation"},{"name":"The King Gustaf V 80th Birthday Fund"},{"DOI":"10.13039\/501100007949","name":"The Swedish Rheumatism Association","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The Swedish Kidney Foundation"},{"name":"Stig and Gunborg Westman\u00b4s Foundation"},{"name":"Dr Margaretha Nilsson Foundation for medical research"},{"DOI":"10.13039\/501100003748","name":"Svenska S\u00e4llskapet f\u00f6r Medicinsk Forskning","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003748","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Rheumatol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Kidney biopsy is the reference tool for diagnosing and guiding treatment strategies in inflammatory renal diseases, such as lupus nephritis (LN).<\/jats:p>\n                <jats:p>We investigated the histopathological findings in first-time kidney biopsies from a large cohort of SLE patients. We focused on the occurrence and type of histopathological findings other than LN, and fulfillment of renal criteria in established SLE classification systems were analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We retrospectively included SLE patients (<jats:italic>n<\/jats:italic>\u2009=\u2009139) who underwent a first kidney biopsy between 1995 and 2021, upon clinical suspicion of renal involvement. Based on histology, two groups were defined, LN and non-LN, for which clinical and laboratory features were compared.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Findings consistent with LN according to ISN\/RPS classification system were present in 123\/139 patients (88.5%) and findings not consistent with LN were present in 16 \/139 (11.5%).<\/jats:p>\n                <jats:p>Non-LN patients were older at SLE diagnosis compared to LN patients (M, years 38.0 vs. 30.1, <jats:italic>p<\/jats:italic>=0.013) and had longer disease duration (M, years 11.9 vs 0.5) (<jats:italic>p<\/jats:italic>=0.027).<\/jats:p>\n                <jats:p>Among non-LN patients 85.7% met the SLICC criteria item for renal SLE, seen in 94.7% in the LN group (ns). For the ACR\/EULAR criteria, 66.7% of the non-LN group fulfilled the criteria compared to 74.8% in LN patients (ns). Proteinuria below the criteria cut-off level (&lt;\u20090.5\u00a0g\/24\u00a0h) was seen in 20% of patients with class III\/IV LN.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our data confirm the importance of kidney biopsy for ruling out the presence of renal pathology other than LN. Patients with low-grade proteinuria may exhibit severe types of LN, which reinforces the need for early biopsies to detect LN.<jats:table-wrap><jats:table><jats:tbody>\n                      <jats:tr>\n                        <jats:td align=\"left\" colspan=\"2\"><jats:bold>Key Points<\/jats:bold>\u2022 <jats:italic>Our findings show that histopathology changes other than lupus nephritis may occur in a significant number of patients with clinical and laboratory signs of novel kidney involvement.<\/jats:italic>\u2022 <jats:italic>Low-grade proteinuria does not exclude findings of active lupus nephritis that require the start of immunosuppressive therapy.<\/jats:italic>\u2022 <jats:italic>The study stresses the importance of performing kidney biopsies also in the presence of low-grade proteinuria or when signs of kidney function abnormalities occur.<\/jats:italic>\u2022 <jats:italic>This is crucial as early detection and prompt initiation of therapy may improve outcomes in lupus nephritis.<\/jats:italic><\/jats:td>\n                      <\/jats:tr>\n                    <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10067-023-06682-w","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T08:02:47Z","timestamp":1689235367000},"page":"2981-2986","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Urinary aberrations in systemic lupus erythematosus not always indicative of lupus nephritis: a cross-sectional cohort study"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2853-9255","authenticated-orcid":false,"given":"Linnea","family":"Karlsson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agneta","family":"Zickert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3396-3244","authenticated-orcid":false,"given":"Elisabet","family":"Svenungsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Schmidt-Mende","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6753-7107","authenticated-orcid":false,"given":"Francesca","family":"Faustini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4514-7706","authenticated-orcid":false,"given":"Iva","family":"Gunnarsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,7,13]]},"reference":[{"issue":"10188","key":"6682_CR1","doi-asserted-by":"publisher","first-page":"2332","DOI":"10.1016\/S0140-6736(19)30237-5","volume":"393","author":"L Durcan","year":"2019","unstructured":"Durcan L, O\u2019Dwyer T, Petri M (2019) Management strategies and future directions for systemic lupus erythematosus in adults. 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