{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:25:06Z","timestamp":1792290306069,"version":"4.4.0"},"reference-count":20,"publisher":"The Journal of Rheumatology","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>Lupus nephritis (LN) may lead to endstage kidney disease (ESKD) in 22% of patients over a period of 15 years, with the risk being particularly higher in diffuse proliferative forms. The rate of kidney function decline varies. However, a catastrophic course leading to ESKD within a few years from onset is uncommon. The aim of the present study was to assess the factors associated with rapid progression to ESKD in patients with LN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>Patients from the Toronto Lupus Clinic with biopsy-proven LN at presentation and estimated glomerular filtration rate (eGFR) 60 mL\/min\/1.73 m<jats:sup>2<\/jats:sup>, who developed ESKD within 3 years were retrieved. Pathology reports were reviewed with particular emphasis on distinct histopathologic features. Demographic, clinical, laboratory, and therapeutic variables were also analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Ten patients (1.8% of the total LN population) developed ESKD within 3 years of diagnosis. Their mean age was 34.2 \u00b1 7.3 years, mean time to ESKD 19.2 \u00b1 12.4 months, initial eGFR 90.2 \u00b1 24.9 mL\/min\/1.73 m<jats:sup>2<\/jats:sup>, proteinuria 2.7 \u00b1 1.04 g\/24 h. The median rate of kidney function decline was &gt; 43 mL\/min\/1.73 m<jats:sup>2<\/jats:sup>\/year. One patient had LN class III, 5 had LN class IV, 2 had membranous LN (class V), and another 2 had mixed IV\/V. Moreover, 2 patients had extensive thrombotic microangiopathy, 1 collapsing glomerulonephritis, and 1 concomitant antiglomerular basement membrane (anti-GBM) nephropathy. Four patients showed no unusual kidney pathology; all of them had severe noncompliance (discontinued all medications to follow alternative treatment).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Catastrophic progression to ESKD is uncommon in LN. The major associated factors are poor compliance and distinct histopathologic features such as thrombotic microangiopathy, collapsing glomerulopathy, and concomitant anti-GBM nephropathy.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.200161","type":"journal-article","created":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T18:30:34Z","timestamp":1598985034000},"page":"228-231","source":"Crossref","is-referenced-by-count":9,"title":["Factors Associated With Rapid Progression to Endstage Kidney Disease in Lupus Nephritis"],"prefix":"10.3899","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2459-7510","authenticated-orcid":false,"given":"Konstantinos","family":"Tselios","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9074-0592","authenticated-orcid":false,"given":"Dafna 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