Kandane-Rathnayake R, Kent JR, Louthrenoo W, et al. - Data from a large multinational prospective cohort was used in this study in order to investigate longitudinal relationships of active lupus nephritis with organ damage accrual in individuals with SLE. Individuals (N = 1,735) were analyzed during 12,717 visits for a median (inter-quartile range) follow-up period of 795 (532, 1,087) days. About 40% of people had evidence of active lupus nephritis at least once during the study period, and active lupus nephritis was noted in 3,030 visits. Organ damage at baseline was noted in 48% and accrued organ damage in 14%. In comparison with those without active lupus nephritis, persons with active lupus nephritis were 52% more inclined to increase any organ damage. Active lupus nephritis was robustly related to damage accrual in renal yet not in non-renal organ domains. No impact of ethnicity on renal damage accrual was noted, yet Asian ethnicity was notably related to decreased non-renal damage accrual.