DOES BASELINE NEPHROTIC RANGE PROTEINURIA DETERMINE THE LONG-TERM OUTCOMES OF MEMBRANOUS LUPUS NEPHRITIS PATIENTS?
Bibliographic record
Abstract
O037 / #680 Topic: AS15 - Lupus Nephritis-Clinical ABSTRACT CONCURRENT SESSION 06: LUPUS NEPHRITIS – CLINICAL OUTCOMES, PREDICTION AND THERAPY 23-05-2025 1:40 PM - 2:40 PM Background/Purpose Management strategies for membranous lupus nephritis (MLN) are generally based on the severity of proteinuria. However, long-term outcomes comparing subnephrotic and nephrotic range proteinuria remain understudied. We explored whether baseline proteinuria level, subnephrotic or nephrotic, impacts long-term outcomes. Methods We conducted a retrospective study identifying patients with biopsy-proven MLN. Patients were categorized based on baseline proteinuria: subnephrotic (<3.5 g/day) or nephrotic (≥3.5 g/day). Long-term outcomes, including an adverse composite outcome (end-stage kidney disease, sustained ≥30% decline in eGFR, or death) and LN flares, were analyzed. Time-to-event outcomes were assessed using Kaplan-Meier curves, and associations were evaluated using Cox regression. Results Eighty-eight patients were included, with 49 (55.7%) in the subnephrotic group (median 1.5 g/day) and 39 (44.3%) in the nephrotic group (median 4.7 g/day). At baseline, the subnephrotic group had a longer time to LN onset, higher serum albumin, less diffuse podocyte effacement, and less frequent cyclophosphamide treatment (Table 1). No significant differences were noted in kidney function, urine sediment abnormalities, or histopathology. 38 patients (43.2%) experienced the adverse composite outcome, with no difference between groups (40.8% in the subnephrotic group vs. 46.2% in the nephrotic group, p=0.78]. Flares occurred in 35 patients (39.8%), with no difference between groups (38.8% in the subnephrotic group vs. 41.0% in the nephrotic group, p=1.00). Kaplan-Meier curves (Figure) and Cox proportional hazards model further confirmed these findings. Table 1. Patient characteristics at the time of LN onset (baseline). Figure. Conclusions No significant differences in renal disease characteristics or long-term outcomes were found between MLN patients with nephrotic and subnephrotic baseline proteinuria. These findings challenge current practices, suggesting a need for more individualized immunosuppressive treatment in MLN.
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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 | 0.001 | 0.003 |
| 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 | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".