{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:00:46Z","timestamp":1777928446814,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2013,6,13]],"date-time":"2013-06-13T00:00:00Z","timestamp":1371081600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:p>Whether the long-term patient and renal survival of those diagnosed with lupus nephritis (LN) has improved over the decades is still debated. Eighty-nine patients diagnosed between 1968 and 1990 entered this study and their outcome was evaluated after 20 years. At presentation 54% of patients had class IV LN, 39.3% had renal insufficiency and 59.5% had nephrotic syndrome. Patients were divided into two groups: Group 1 consisted of 30 patients diagnosed between 1968 and 1980; Group 2 consisted of 59 patients diagnosed between 1981 and 1990. In Group 1 patient survival at 20 years was 84% versus 95% in Group 2 ( p\u2009=\u20090.05). Survivals without end-stage renal failure were respectively 75% and 84% at 20 years ( p\u2009=\u20090.05). Survivals without severe infection at 20 years were 44% in Group 1 and 66.5% in Group 2 ( p\u2009=\u20090.02). Survivals without cardiovascular events at 20 years were: 53% in Group 1 and 90% in Group 2 ( p\u2009=\u20090.005). At presentation, patients in Group 1 had higher serum creatinine (1.96\u2009vs 1.15\u2009mg\/dl, p\u2009=\u20090.01), higher activity index (8\u2009vs 5.5, p\u2009=\u20090.01), lower hematocrit (31% v s6%, p\u2009=\u20090.008) and lower serum C4 levels ( p\u2009=\u20090.04) than Group 2 patients. Patients in Group 1 also received less frequent methylprednisolone pulses (43% v s81%, p\u2009=\u20090.0006). In Italian patients with LN, long-term life expectancy and renal survival progressively improved over the decades, while morbidity progressively declined. An earlier referral and refinement of therapy achieved this goal.<\/jats:p>","DOI":"10.1177\/0961203313492576","type":"journal-article","created":{"date-parts":[[2013,6,13]],"date-time":"2013-06-13T20:17:53Z","timestamp":1371154673000},"page":"810-818","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":44,"title":["Progressive improvement of patient and renal survival and reduction of morbidity over time in patients with lupus nephritis (LN) followed for 20 years"],"prefix":"10.1177","volume":"22","author":[{"given":"G","family":"Moroni","sequence":"first","affiliation":[{"name":"Unita\u2019 Operativa di Nefrologia e Dialisi, Fondazione Ospedale Maggiore Policlinico, Mangiagalli, Regina Elena IRCCS, Italy, 2Dipartimento di Informatica e Sistemistica, Universita\u2019 degli Studi di Pavia, Italy, 3Divisione di Nefrologia e Dialisi, Azienda Ospedaliera Sant\u2019Anna, Italy, and 4Divisione di Nefrologia, IRCCS Istituto Humanitas, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Quaglini","sequence":"additional","affiliation":[{"name":"Unita\u2019 Operativa di Nefrologia e Dialisi, Fondazione Ospedale Maggiore Policlinico, Mangiagalli, Regina Elena IRCCS, Italy, 2Dipartimento di Informatica e Sistemistica, Universita\u2019 degli Studi di Pavia, Italy, 3Divisione di Nefrologia e Dialisi, Azienda Ospedaliera Sant\u2019Anna, Italy, and 4Divisione di Nefrologia, IRCCS Istituto Humanitas, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Gallelli","sequence":"additional","affiliation":[{"name":"Unita\u2019 Operativa di Nefrologia e Dialisi, Fondazione Ospedale Maggiore Policlinico, Mangiagalli, Regina Elena IRCCS, Italy, 2Dipartimento di Informatica e Sistemistica, Universita\u2019 degli Studi di Pavia, Italy, 3Divisione di Nefrologia e Dialisi, Azienda Ospedaliera Sant\u2019Anna, Italy, and 4Divisione di Nefrologia, IRCCS Istituto Humanitas, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Banfi","sequence":"additional","affiliation":[{"name":"Unita\u2019 Operativa di Nefrologia e Dialisi, Fondazione Ospedale Maggiore Policlinico, Mangiagalli, Regina Elena IRCCS, Italy, 2Dipartimento di Informatica e Sistemistica, Universita\u2019 degli Studi di Pavia, Italy, 3Divisione di Nefrologia e Dialisi, Azienda Ospedaliera Sant\u2019Anna, Italy, and 4Divisione di Nefrologia, IRCCS Istituto Humanitas, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Messa","sequence":"additional","affiliation":[{"name":"Unita\u2019 Operativa di Nefrologia e Dialisi, Fondazione Ospedale Maggiore Policlinico, Mangiagalli, Regina Elena IRCCS, Italy, 2Dipartimento di Informatica e Sistemistica, Universita\u2019 degli Studi di Pavia, Italy, 3Divisione di Nefrologia e Dialisi, Azienda Ospedaliera Sant\u2019Anna, Italy, and 4Divisione di Nefrologia, IRCCS Istituto Humanitas, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Ponticelli","sequence":"additional","affiliation":[{"name":"Unita\u2019 Operativa di Nefrologia e Dialisi, Fondazione Ospedale Maggiore Policlinico, Mangiagalli, Regina Elena IRCCS, Italy, 2Dipartimento di Informatica e Sistemistica, Universita\u2019 degli Studi di Pavia, Italy, 3Divisione di Nefrologia e Dialisi, Azienda Ospedaliera Sant\u2019Anna, Italy, and 4Divisione di Nefrologia, IRCCS Istituto Humanitas, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,6,13]]},"reference":[{"key":"bibr1-0961203313492576","first-page":"1259","volume":"22","author":"Abu-Shakra M","year":"1995","journal-title":"J 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