Wang H, Ren YL, Chang J, Gu L, Sun LY. A systematic review and meta-analysis of prevalence of biopsy-proven lupus nephritis. Arch Rheumatol. 2018;33(1):17–25. https://doi.org/10.5606/ArchRheumatol.2017.6127.

Article  PubMed  Google Scholar 

Gergianaki I, Fanouriakis A, Repa A, Tzanakakis M, Adamichou C, Pompieri A, et al. Epidemiology and burden of systemic lupus erythematosus in a Southern European population: data from the community-based lupus registry of Crete. Greece Ann Rheum Dis. 2017;76(12):1992–2000. https://doi.org/10.1136/annrheumdis-2017-211206.

Article  PubMed  Google Scholar 

Delfino J, Dos Santos T, Skare TL. Comparison of lupus patients with early and late onset nephritis: a study in 71 patients from a single referral center. Adv Rheumatol. 2020;60(1):5. https://doi.org/10.1186/s42358-019-0105-5.

Article  PubMed  Google Scholar 

Moroni G, Vercelloni PG, Quaglini S, Gatto M, Gianfreda D, Sacchi L, et al. Changing patterns in clinical-histological presentation and renal outcome over the last five decades in a cohort of 499 patients with lupus nephritis. Ann Rheum Dis. 2018;77(9):1318–25. https://doi.org/10.1136/annrheumdis-2017-212732.

Article  CAS  PubMed  Google Scholar 

Fanouriakis A, Kostopoulou M, Cheema K, Anders HJ, Aringer M, Bajema I, et al. 2019 Update of the Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis. Ann Rheum Dis. 2020;79(6):713–23. https://doi.org/10.1136/annrheumdis-2020-216924.

Article  CAS  PubMed  Google Scholar 

Kostopoulou M, Adamichou C, Bertsias G. An update on the diagnosis and management of lupus nephritis. Curr Rheumatol Rep. 2020;22(7):30. https://doi.org/10.1007/s11926-020-00906-7.

Article  PubMed  Google Scholar 

Kostopoulou M, Pitsigavdaki S, Bertsias G. Lupus nephritis: improving treatment options. Drugs. 2022;82(7):735–48. https://doi.org/10.1007/s40265-022-01715-1.

Article  CAS  PubMed  Google Scholar 

Bertsias G. Recommendations for systemic lupus erythematosus: balancing evidence and eminence to facilitate the medical care of a complex disease. Rheum Dis Clin North Am. 2022;48(3):617–36. https://doi.org/10.1016/j.rdc.2022.05.001.

Article  PubMed  Google Scholar 

Hocaoglu M, Valenzuela-Almada MO, Dabit JY, Osei-Onomah SA, Chevet B, Giblon RE, et al. Incidence, prevalence, and mortality of lupus nephritis: a population-based study over four decades using the lupus midwest network. Arthritis Rheumatol. 2023;75(4):567–73. https://doi.org/10.1002/art.42375.

Article  PubMed  Google Scholar 

Tektonidou MG, Dasgupta A, Ward MM. Risk of end-stage renal disease in patients with lupus nephritis, 1971–2015: a systematic review and Bayesian meta-analysis. Arthritis Rheumatol. 2016;68(6):1432–41. https://doi.org/10.1002/art.39594.

Article  PubMed  PubMed Central  Google Scholar 

Mahajan A, Amelio J, Gairy K, Kaur G, Levy RA, Roth D, et al. Systemic lupus erythematosus, lupus nephritis and end-stage renal disease: a pragmatic review mapping disease severity and progression. Lupus. 2020;29(9):1011–20. https://doi.org/10.1177/0961203320932219.

Article  PubMed  PubMed Central  Google Scholar 

Thanou A, Jupe E, Purushothaman M, Niewold TB, Munroe ME. Clinical disease activity and flare in SLE: current concepts and novel biomarkers. J Autoimmun. 2021;119:102615. https://doi.org/10.1016/j.jaut.2021.102615.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Adamichou C, Bertsias G. Flares in systemic lupus erythematosus: diagnosis, risk factors and preventive strategies. Mediterr J Rheumatol. 2017;28(1):4–12. https://doi.org/10.31138/mjr.28.1.4.

Article  PubMed  PubMed Central  Google Scholar 

Tamirou F, D’Cruz D, Sangle S, Remy P, Vasconcelos C, Fiehn C, et al. Long-term follow-up of the MAINTAIN nephritis trial, comparing azathioprine and mycophenolate mofetil as maintenance therapy of lupus nephritis. Ann Rheum Dis. 2016;75(3):526–31. https://doi.org/10.1136/annrheumdis-2014-206897.

Article  CAS  PubMed  Google Scholar 

• Rovin BH, Furie R, Teng YKO, Contreras G, Malvar A, Yu X, et al. A secondary analysis of the Belimumab International Study in Lupus Nephritis trial examined effects of belimumab on kidney outcomes and preservation of kidney function in patients with lupus nephritis. Kidney Int. 2022;101(2):403–13. https://doi.org/10.1016/j.kint.2021.08.027. Post-hoc analysis of the BLISS-LN trial demonstrates the salutary effect of belimumab in combination with standard therapy on prevention of flares and renal function decline.

Article  CAS  PubMed  Google Scholar 

Arriens C, Parikh S, Hodge L, Mela C, Leher H. Assessment of long-term safety and efficacy including renal outcome over three years of treatment in the phase 3 AURORA 1 and AURORA 2 studies. [abstract]. Arthritis Rheumatol. 2022;74 (suppl 9).

Pirson V, Enfrein A, Houssiau FA, Tamirou F. Absence of renal remission portends poor long-term kidney outcome in lupus nephritis. Lupus Sci Med. 2021;8(1): e000533. https://doi.org/10.1136/lupus-2021-000533.

Kapsia E, Marinaki S, Michelakis I, Liapis G, Sfikakis PP, Boletis J, et al. Predictors of early response, flares, and long-term adverse renal outcomes in proliferative lupus nephritis: a 100-month median follow-up of an inception cohort. J Clin Med. 2022;11(17):5017. https://doi.org/10.3390/jcm11175017.

Luis MSF, Bultink IEM, da Silva JAP, Voskuyl AE, Ines LS. Early predictors of renal outcome in patients with proliferative lupus nephritis: a 36-month cohort study. Rheumatology (Oxford). 2021;60(11):5134–41. https://doi.org/10.1093/rheumatology/keab126.

Article  CAS  PubMed  Google Scholar 

Mok CC, Ho LY, Ying SKY, Leung MC, To CH, Ng WL. Long-term outcome of a randomised controlled trial comparing tacrolimus with mycophenolate mofetil as induction therapy for active lupus nephritis. Ann Rheum Dis. 2020;79(8):1070–6. https://doi.org/10.1136/annrheumdis-2020-217178.

Article  PubMed  Google Scholar 

Okamoto M, Kitamura M, Sato S, Fujikawa K, Horai Y, Matsuoka N, et al. Life prognosis and renal relapse after induction therapy in Japanese patients with proliferative and pure membranous lupus nephritis. Rheumatology (Oxford). 2021;60(5):2333–41. https://doi.org/10.1093/rheumatology/keaa599.

Article  CAS  PubMed  Google Scholar 

Momtaz M, Fayed A, Wadie M, Gamal SM, Ghoniem SA, Sobhy N, et al. Retrospective analysis of nephritis response and renal outcome in a cohort of 928 Egyptian lupus nephritis patients: a university hospital experience. Lupus. 2017;26(14):1564–70. https://doi.org/10.1177/0961203317716320.

Article  CAS  PubMed  Google Scholar 

Yap DYH, Tang C, Ma MKM, Mok MMY, Chan GCW, Kwan LPY, et al. Longterm data on disease flares in patients with proliferative lupus nephritis in recent years. J Rheumatol. 2017;44(9):1375–83. https://doi.org/10.3899/jrheum.170226.

Article  CAS  PubMed  Google Scholar 

Ugarte-Gil MF, Acevedo-Vasquez E, Alarcon GS, Pastor-Asurza CA, Alfaro-Lozano JL, Cucho-Venegas JM, et al. The number of flares patients experience impacts on damage accrual in systemic lupus erythematosus: data from a multiethnic Latin American cohort. Ann Rheum Dis. 2015;74(6):1019–23. https://doi.org/10.1136/annrheumdis-2013-204620.

Article  CAS  PubMed  Google Scholar 

Gatto M, Radice F, Saccon F, Calatroni M, Frontini G, Trezzi B, et al. Clinical and histological findings at second but not at first kidney biopsy predict end-stage kidney disease in a large multicentric cohort of patients with active lupus nephritis. Lupus Science & Medicine 2022;9:e000689. https://doi.org/10.1136/lupus-2022-000689.

• Moroni G, Porata G, Raffiotta F, Frontini G, Calatroni M, Reggiani F, et al. Predictors of increase in chronicity index and of kidney function impairment at repeat biopsy in lupus nephritis. Lupus Science & Medicine 2022;9:e000721. https://doi.org/10.1136/lupus-2022-000721. One of the largest European cohorts of lupus nephritis which identifies predictors of clinical and histological deterioration at repeat kidney biopsy.

Anders HJ, Saxena R, Zhao MH, Parodis I, Salmon JE, Mohan C. Lupus nephritis. Nat Rev Dis Primers. 2020;6(1):7. https://doi.org/10.1038/s41572-019-0141-9.

Article  PubMed  Google Scholar 

Rijnink EC, Teng YKO, Wilhelmus S, Almekinders M, Wolterbeek R, Cransberg K, et al. Clinical and histopathologic characteristics associated with renal outcomes in lupus nephritis. Clin J Am Soc Nephrol. 2017;12(5):734–43. https://doi.org/10.2215/CJN.10601016.

Article  PubMed  PubMed Central  Google Scholar 

Parikh SV, Nagaraja HN, Hebert L, Rovin BH. Renal flare as a predictor of incident and progressive CKD in patients with lupus nephritis. Clin J Am Soc Nephrol. 2014;9(2):279–84. https://doi.org/10.2215/CJN.05040513.

Article  PubMed  Google Scholar 

Perez-Arias AA, Marquez-Macedo SE, Pena-Vizcarra OR, Zavala-Miranda MF, Romero-Diaz J, Morales-Buenrostro LE, et al. The influence of repeated flares in response to therapy and prognosis in lupus nephritis. Nephrol Dial Transplant. 2023;38(4):884–93. https://doi.org/10.1093/ndt/gfac304.

Article  PubMed  Google Scholar 

Mejia-Vilet JM, Cordova-Sanchez BM, Arreola-Guerra JM, Morales-Buenrostro LE, Uribe-Uribe NO, Correa-Rotter R. Renal flare prediction and prognosis in lupus nephritis Hispanic patients. Lupus. 2016;25(3):315–24. https://doi.org/10.1177/0961203315606985.

Article  CAS  PubMed  Google Scholar 

Moroni G, Quaglini S, Maccario M, Banfi G, Ponticelli C. “Nephritic flares” are predictors of bad long-term renal outcome in lupus nephritis. Kidney Int. 1996;50(6):2047–53. https://doi.org/10.1038/ki.1996.528.

Article  CAS  PubMed  Google Scholar 

Mosca M, Bencivelli W, Neri R, Pasquariello A, Batini V, Puccini R, et al. Renal flares in 91 SLE patients with diffuse proliferative glomerulonephritis. Kidney Int. 2002;61(4):1502–9. https://doi.org/10.1046/j.1523-1755.2002.00280.x.

Article  PubMed  Google Scholar 

Jolly M, Galicier L, Aumaitre O, Frances C, Le Guern V, Liote F, et al. Quality of life in systemic lupus erythematosus: description in a cohort of French patients and association with blood hydroxychloroquine levels. Lupus. 2016;25(7):735–40. https://doi.org/10.1177/0961203315627200.

Article  CAS  PubMed  Google Scholar 

Bell CF, Huang SP, Cyhaniuk A, Averell CM. The cost of flares among patients with systemic lupus erythematosus with and without lupus nephritis in the United States. Lupus. 2023;32(2):301–9. https://doi.org/10.1177/09612033221146093.

Article  CAS  PubMed  Google Scholar 

Thompson JC, Mahajan A, Scott DA, Gairy K. The economic burden of lupus nephritis: a systematic literature review. Rheumatol Ther. 2022;9(1):25–47. https://doi.org/10.1007/s40744-021-00368-y.

Article  PubMed  Google Scholar 

Bertsias G, Karampli E, Sidiropoulos P, Gergianaki I, Drosos A, Sakkas L, et al. Clinical and financial burden of active lupus in Greece: a nationwide study. Lupus. 2016;25(12):1385–94. https://doi.org/10.1177/0961203316642310.

Article  CAS  PubMed  Google Scholar 

Chen Y, Huang S, Chen T, Liang D, Yang J, Zeng C, et al. Machine learning for prediction and risk stratification of lupus nephritis renal flare. Am J Nephrol. 2021;52(2):152–60. https://doi.org/10.1159/000513566.

Article  CAS