CLINICAL AND PATHOLOGICAL CHARACTERISTICS OF PATIENTS WITH LUPUS NEPHRITIS AND CONCOMITANT TMA
Bibliographic record
Abstract
PV137 / #64 Poster Topic: AS16 - Lupus Nephritis-Pathogenesis Background/Purpose Thrombotic microangiopathy (TMA) can be seen in up to 24% of patients with lupus nephritis and may be renally limited or have systemic manifestations. It may also occur in the setting of autoimmunity, with an overall poor prognosis. This study examines a cohort of patients with biopsy-proven lupus nephritis with concomitant TMA lesions on kidney biopsy, highlighting their clinical associations and outcomes. Methods We reviewed medical records of 255 patients with biopsy-proven lupus nephritis from June 2015 to December 2023 at Houston Methodist Hospital, identifying 7 patients with concomitant TMA on renal biopsy. We manually extracted pathological and clinical characteristics of these patients from their electronic medical record. Results Three patients (43%) developed ESRD requiring hemodialysis without remission. The remaining had partial remission, with a mean creatinine of 1.2 ± 0.4 mg/dL, GFR 68 ± 15.7 mL/min, and UPCR 0.9 ± 0.6 mg/mg around 6 months of follow-up. Induction therapy varied: mycophenolate (3), belimumab (1), cyclophosphamide (2), and rituximab (1). All patients received concurrent hydroxychloroquine and prednisone. Results are summarized below (Table 1, Table 2, Table 3): Table 1. Cohort Demographic Characteristics Table 2. Cohort Serologies Table 3. Pertinent Labs Conclusions In this study, there was a higher prevalence of African Americans, obesity, and tobacco use in patients with lupus nephritis and TMA. Only 29% of our cohort had antiphospholipid syndrome, illustrating that not all TMA is associated with APLS. Importantly, 43% of our cohort progressed to ESRD. Vigilant monitoring and larger studies should be done to better characterize TMA diagnosis on biopsy as a significant risk factor for poor outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".