{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T10:14:40Z","timestamp":1783332880218,"version":"3.54.6"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To clarify long-term prognosis and its relevant factors in patients with pure class V lupus nephritis (LN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed consecutive patients with biopsy-proven pure class V LN from KEIO-SLE cohort. The treatment target and deep remission (DR) were defined as urine protein-to-creatinine ratio\u2009&amp;lt;0.7\u00a0g\/gCr and\u2009&amp;lt;0.15\u00a0g\/gCr, respectively. Patients were divided into two groups based on the occurrence of renal flare, and baseline clinical and pathological characteristics were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty patients with pure class V LN were included. All patients achieved the treatment target. Among them, seven patients (23.3%) experienced renal flare. In the Firth\u2019s penalized Cox regression analysis, univariate analysis showed that smoking history, glucocorticoid monotherapy throughout follow-up, anti-ribonucleoprotein antibody positivity, Chronicity index \u22653, and non-achievement of DR were associated with an increased risk of renal flare. Multivariable analysis revealed that only non-achievement of DR remained an independent risk factor. Kaplan\u2013Meier analyses showed significantly lower flare-free survival in patients with these risk factors. No patients developed end-stage kidney disease during a median observation period of 85.6\u00a0months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Overall long-term prognosis of pure class V LN was favourable. However, approximately one-quarter of patients experienced renal flares. Failure to achieve DR, smoking history, throughout glucocorticoid monotherapy, and anti-ribonucleoprotein antibody positivity were associated with an increased risk of renal flare, with failure to achieve DR being the only independent risk factor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/mr\/roaf129","type":"journal-article","created":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T12:50:03Z","timestamp":1766667003000},"page":"574-580","source":"Crossref","is-referenced-by-count":0,"title":["Impact of deep remission on renal flare in pure class V lupus nephritis: results from KEIO-SLE cohort, a retrospective cohort study"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2392-8516","authenticated-orcid":false,"given":"Masatoshi","family":"Kawai","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5172-1102","authenticated-orcid":false,"given":"Hironari","family":"Hanaoka","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Fukui","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuoto","family":"Hiramoto","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Takei","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, 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