FRI0374 Milder clinical presentation of lupus nephritis and improved renal survival during the last 50 years: a multicentric study

Background Lupus nephritis (LN) presentation changed over time following earlier diagnosis and treatment. Objectives To evaluate changes in LN clinical and histological presentation in the last 5 decades. Methods This is a retrospective multicentric study on prospectively collected data in four Italian hospital centres. Patients diagnosed between 1970 and 2016 were recruited provided they had a biopsy-proven LN that was retrospectively reclassified according to the ISN/RPS classification criteria. Follow-up was subdivided into three periods (P) based on the year of LN diagnosis: P1:1970–1895; P2:1986–2000; P3:2001–2016. Predictors of patient and renal survival were investigated by univariate and multivariate analysis; survival curves were compared by log-rank test. Clinical pictures at presentation included isolated urinary abnormalities, nephrotic syndrome, nephritic syndrome, rapidly progressive renal failure. Outcome at last observation was defined as complete renal remission or partial renal remission, or poor renal outcome, including chronic kidney disease (CKD) or end stage renal disease (ESRD). Results 499 patients were included (85.6% females) with a median follow-up of 10.6 years (IQR 4–18). We observed an increase in both age at diagnosis of LN (P1 28.4±10.4; P2 29±11.5; P3 34.4±13.3 years) and disease duration before LN diagnosis (P1 1.3±1.3; P2 2.6±4.5; P3 4.6±6.3 years) from 1970 to 2016 (p Conclusions The clinical presentation of LN apparently became less severe in the last decades, likely due to earlier diagnosis and proper treatment, leading to an improved renal survival. Disclosure of Interest None declared