Qiu S, Zhang H, Yu S, et al. - The results showed that pediatric lupus nephritis (pLN) is usually presented with proteinuria, and class IV LN was the dominant pathology. The outcomes suggested that at diagnosis, Hypertension, nervous-system involvement, treatment non-compliance, and lower eGFR were independent risk factors for poor prognosis of kidney outcomes. Compared with renal remission rate and cumulative overall survival rate, the proportion of targets achieved was not ideal, suggesting treat-to-target (T2T) strategy should be used to guide pLN management.

• Proteinuria was the most common pLN manifestation (81.36%). Compared with males, females presented more often with rash (P<0.001) and alopecia (P=0.026).

• The most common grade on kidney biopsy was Class IV LN (33.33%).

• In this study, 27.20 months was the median follow-up (IQR, 15.78–44.45 months).

• As per the results, 93.5%, 87.8%, and 86.5% were the one-, 3-, and 5-year cumulative overall survival rates.

• Furthermore, 97.1% was the 5-year cumulative kidney survival rate.

• Regarding initial therapy, the data indicated that the effectiveness of corticosteroids combined with immunosuppressive agents was significantly better than corticosteroids alone (P=0.010).

• The data illustrated that factors with P<0.05 in univariate analysis, including hypoalbuminemia, higher SCr at diagnosis, lower eGFR at diagnosis, anti-dsDNA positivity, heavy proteinuria, hypertension, nervous-system involvement, treatment non-compliance, and SLEDAI-2K score, were applied for logistic regression analysis.

• In logistic regression analysis, results demonstrated hypertension (OR=0.845, P=0.011), nervous-system involvement (OR=4.240, P=0.005), treatment non-compliance (OR=6.433, P=0.001), and lower estimated glomerular filtration rate at diagnosis (OR=1.020, P=0.021) affected prognosis.

• The findings indicated that 34.31% achieved varying levels of remission, and 8.76% were in a low disease activity state (LDAS) at the end of follow-up.