{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:11:23Z","timestamp":1777929083312,"version":"3.51.4"},"reference-count":43,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T00:00:00Z","timestamp":1694649600000},"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":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We present clinical, biochemical, and histopathological characteristics and treatment outcomes of biopsy proven childhood lupus nephritis (LN) from a low\/middle income setting treated in the current era of increased use of Mycophenolate Mofetil (MMF) and biologics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective observational study of children (1\u201318\u00a0years) with biopsy proven LN treated from 01.01.2010 to 31.01.2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      60 children met our inclusion criteria (80%, n = 48 were females). The median age at diagnosis was 11 (IQR: 9\u201312) years. The most common extra-renal manifestation was mucocutaneous ( n = 54, 90%) and the most common kidney manifestation was edema ( n = 50, 83.3%). The median 24-h urinary protein excretion was 1117.8 (IQR: 795.4\u20131941.7) mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      \/day with 67% ( n = 40) having nephrotic range proteinuria (&gt;1000\u00a0mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      \/day). 75% ( n = 45) children had eGFR &lt;90\u00a0mL\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      (median eGFR = 71; IQR: 56\u201390\u00a0mL\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      ). Anti-Nuclear Antibody was positive in all, both complement three and four were low in 82% ( n = 49) and anti-double stranded DNA antibodies were positive in 63% ( n = 38). 85% ( n = 51) had proliferative LN with majority being class IV (57%, n = 34). All children received steroids for induction therapy. MMF was given as the sole induction agent in 48% ( n = 29) and cyclophosphamide in 27% ( n = 16). Rituximab was added in 17% ( n = 10) as a rescue agent. Median follow up duration was 50 (IQR: 28\u201382) months. Six children (10%) died as a result of serious infections and none of them had shown complete response (CR). Out of the 52 children who had a follow up duration of at least 2\u00a0years, CR was achieved in 46 children (88%) and partial response (PR) or no response (NR) in three children (6%) each. Although children who were in CR\/PR at last follow up had lower proteinuria, higher eGFR, and lower histopathology activity index at onset; low numbers in the NR group precluded us from subjecting them to any statistical correlation tests. 36% ( n = 22) of children developed 36 episodes of renal flares with overall incidence of 0.14\/person-year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study on a contemporary cohort of childhood LN highlights the importance of achieving CR and its feasibility.<\/jats:p>\n                  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