{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T21:03:52Z","timestamp":1771967032670,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,9,22]],"date-time":"2024-09-22T00:00:00Z","timestamp":1726963200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Clinical manifestations and risk factors associated with systemic lupus erythematosus (SLE) flares, including recurrent lupus nephritis (LN), in patients with LN who undergo kidney transplantation have been unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Kidney transplant recipients with LN from January 1995 to December 2021 were included in this study. A disease flare was defined as either an increase in the non\u2010renal SLE disease activity index score or the presence of biopsy\u2010proven recurrent LN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among a total of 93 patients with LN who underwent kidney transplantation, 11 patients (11.8%) experienced SLE flares during a median follow\u2010up period of 76.9\u2009months (IQR, 43.0\u2013122.4). The most common clinical manifestations of SLE flares were recurrent LN (4\/11, 36.4%) and hematologic manifestations (4\/11, 36.4%). Patients who had flares had significantly higher anti\u2010double\u2010stranded DNA (anti\u2010dsDNA) antibody titers both before and after transplantation. Furthermore, an increased anti\u2010dsDNA antibody level before transplantation was associated with a high risk of an SLE flare (HR, 1.030; <jats:italic>p<\/jats:italic>\u2009=\u2009.008). Conversely, preemptive transplantation was associated with a lower risk of a flare (HR, 0.617; <jats:italic>p<\/jats:italic>\u2009=\u2009.026). The rate of patient death\u2010censored graft survival was found to be considerably lower in patients with recurrent LN than in those without LN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Approximately 10% of patients with LN experienced an SLE flare after transplantation, with recurrent LN being the most frequent manifestation. Anti\u2010dsDNA antibody titers before transplantation were significantly related to the risk of an SLE flare. Notably, preemptive transplantation was associated with a reduced risk of flares following transplantation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.15349","type":"journal-article","created":{"date-parts":[[2024,9,22]],"date-time":"2024-09-22T12:50:41Z","timestamp":1727009441000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Lupus flare and recurrent lupus nephritis following kidney transplantation in patients with lupus nephritis"],"prefix":"10.1111","volume":"27","author":[{"given":"Young\u2010Eun","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Asan Medical Center University of Ulsan College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin\u2010Myung","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan 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