{
  "abstract": "Objectives Early reduction in proteinuria is an important predictor of favorable outcomes in patients with Lupus Nephritis (LN). To date, few studies have explored the longitudinal kinetics of 24-hour proteinuria (24hr UP) in real-world settings. We aimed to identify distinct 24hr UP trajectories over 24 months in a contemporary LN cohort and determine baseline predictors, as well as clinical outcomes associated with each trajectory.Methods A multicenter cohort study of patients with biopsy-proven LN was established. Repeated 24hr UP measurements were analyzed using latent class trajectory modelling (LCTM). Baseline clinical, laboratory, and histological characteristics were compared across latent classes by multinomial logistic regression, and an elastic-net regularized approach with cross-validation was applied to identify independent baseline predictors of class assignment. Outcomes at 24 months were compared across trajectories.Results 174 LN patients with a total of 998 study visits were included. The analysis revealed three distinct 24hr UP trajectories: (a) rapid responders (n=70, class 1), (b) suboptimal responders (n=63, class 2), and (c) non-responders (n=41, class 3) ( figure 1a). In multivariate multinomial regression analysis, with class 1 as the reference group, higher baseline proteinuria (Class 2: OR 1.94, p< 0.001; Class 3: OR 1.52, p= 0.006), greater SDI (Class 2: OR 2.81, p= 0.046), and higher crescent count (Class 2: OR 1.46, p= 0.032; Class 3: OR 1.49, p= 0.024) independently predicted suboptimal or no response of proteinuria.At 24 months, estimated glomerular filtration rate (eGFR) varied significantly across trajectory classes, with the lowest mean eGFR observed among non-responders (- 12.6 mL/min/1.73 m2 vs. rapid responders, p= 0.047), consistent with worse renal outcomes in patients with persistent proteinuria (figure 1b).Abstract S9:04 Figure 1Conclusions Three distinct trajectories of proteinuria were identified in a real-world multicenter LN cohort. Higher baseline proteinuria, increased damage, and histologic activity independently predicted inclusion in the non-response trajectory and identified patients at greater risk of GFR compromise at 24 months.",
  "authors": [
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology Unit, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece"
      ],
      "name": "Maria Pappa"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology Unit, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece"
      ],
      "name": "Spyridon Katechis"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology Unit, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece"
      ],
      "name": "Sofia Flouda"
    },
    {
      "affiliations": [
        "Department of Rheumatology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece"
      ],
      "name": "Antigone Pieta"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology, University of Crete, Medical School and University Hospital of Iraklio, Iraklio, Greece"
      ],
      "name": "Myrto Nikoloudaki"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University Hospital of Larissa, Larissa, Greece"
      ],
      "name": "Nektarios -Mario Liapis"
    },
    {
      "affiliations": [
        "Clinical Immunology- Rheumatology Unit, 2nd Department of Medicine and Laboratory, General Hospital of Athens Ippokratio, Athens, Greece"
      ],
      "name": "Christina Tsalapaki"
    },
    {
      "affiliations": [
        "Nephrology Department, General Hospital of Athens Hippokration, Athens, Greece"
      ],
      "name": "Aglaia Chalkia"
    },
    {
      "affiliations": [
        "Rheumatology Unit, Sismanogleio General Hospital of Athens, Athens, Greece"
      ],
      "name": "Evangelia Argyriou"
    },
    {
      "affiliations": [
        "Fourth Department of Internal Medicine, Hippokration University Hospital, Thessaloniki, Greece"
      ],
      "name": "Theodoros Dimitroulas"
    },
    {
      "affiliations": [
        "Rheumatology Clinic, Evangelismos General Hospital of Athens, Athens, Greece"
      ],
      "name": "Myrto Cheila"
    },
    {
      "affiliations": [
        "First Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece"
      ],
      "name": "Charalampos Papagoras"
    },
    {
      "affiliations": [
        "Department of Pathophysiology, National and Kapodistrian University of Athens, Athens, Greece"
      ],
      "name": "Andreas V Goules"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University Hospital of Larissa, Larissa, Greece"
      ],
      "name": "Christina Katsiari"
    },
    {
      "affiliations": [
        "Clinical Immunology- Rheumatology Unit, 2nd Department of Medicine and Laboratory, General Hospital of Athens Ippokratio, Athens, Greece"
      ],
      "name": "Dimitrios Vassilopoulos"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology, University of Crete, Medical School and University Hospital of Iraklio, Iraklio, Greece"
      ],
      "name": "Prodromos Sidiropoulos"
    },
    {
      "affiliations": [
        "Rheumatology Unit, Sismanogleio General Hospital of Athens, Athens, Greece"
      ],
      "name": "Kyriaki A Boki"
    },
    {
      "affiliations": [
        "First Department of Propaedeutic and Internal Medicine, and Joint Rheumatology Program, National and Kapodistrian Univ, Athens, Greece"
      ],
      "name": "Petros P Sfikakis"
    },
    {
      "affiliations": [
        "First Department of Pathology, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece"
      ],
      "name": "George Liapis"
    },
    {
      "affiliations": [
        "First Department of Pathology, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece"
      ],
      "name": "Charikleia Gakiopoulou"
    },
    {
      "affiliations": [
        "Department of Pathology and Cytology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece"
      ],
      "name": "Foteini Karasavvidou"
    },
    {
      "affiliations": [
        "Department of Rheumatology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece"
      ],
      "name": "Paraskevi V Voulgari"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology Unit, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece"
      ],
      "name": "Dimitrios Boumpas"
    },
    {
      "affiliations": [
        "First Department of Propaedeutic and Internal Medicine, and Joint Rheumatology Program, National and Kapodistrian Univ, Athens, Greece"
      ],
      "name": "Maria G Tektonidou"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology, University of Crete, Medical School and University Hospital of Iraklio, Iraklio, Greece"
      ],
      "name": "George K Bertsias"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology Unit, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece"
      ],
      "name": "Antonis Fanouriakis"
    }
  ],
  "title": "S9:04 Trajectories of proteinuria in lupus nephritis and association with kidney function decline at 2 years",
  "uid": "92c5485c-487a-566f-9163-b948b933fa32"
}