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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Elderly-onset lupus nephritis (LN) is increasing in prevalence but remains insufficiently characterized, particularly regarding treatment response and long-term prognosis. This study aimed to clarify the clinical features, histopathology, treatments, and outcomes of elderly LN patients in Japan.
A multicenter retrospective study was conducted using the Japan Renal Biopsy Registry (J-RBR). Patients with biopsy-confirmed, new-onset LN between 2007 and 2012 were included and stratified into elderly (≥50 years) and younger (<50 years) groups. Baseline clinical parameters, ISN/RPS classification, and initial immunosuppressive therapy were assessed. Outcomes included ≥1.5-fold increase in serum creatinine (S-Cr), doubling of S-Cr or end-stage kidney disease (ESKD), and all-cause mortality. Kaplan–Meier analyses and Cox proportional hazards models were used.
Among 348 patients with new-onset LN, 107 (30.7%) were aged ≥50 years. Elderly patients presented with higher systolic blood pressure (132.8±23.7 vs 124.0±19.4 mmHg, P<0.001) and lower eGFR (64.7±27.5 vs 86.0±34.3 mL/min/1.73m2, P<0.001), while proteinuria was comparable to that of younger patients (3.22±3.24 vs 3.08±3.22 g/gCr, P=0.713). Histologically, Class IV LN was less frequent (36.4% vs. 51.0%), whereas Class V was more common (26.2% vs. 14.9%) in the elderly. The use of mycophenolate mofetil (MMF)/cyclophosphamide (CY) and the initial doses of GC were lower in the elderly group (38.1±15.3 vs 43.2±14.5 mg/day, prednisolone (PSL)-equivalent, P=0.004). During a median follow-up of 62.4 months, elderly patients showed significantly poorer renal outcomes. The incidence of a ≥1.5-fold increase in S-Cr and doubling of S-Cr/ESKD was higher in elderly patients (log-rank P = 0.034 and 0.012, respectively). Mortality was markedly increased (P<0.001), predominantly due to infections. In the Cox models adjusted for sex, baseline S-Cr, proteinuria, and treatment, older age was associated with an increased risk of doubling of S-Cr or progression to ESKD (HR 2.54, 95% CI 1.05–6.15) and death (HR 5.12, 95% CI 1.97–13.3). Among elderly patients who received a PSL-equivalent dose of ≥0.5 mg/kg/day, renal outcomes (1.5-fold increase in S-Cr) were compared across three initial treatment groups: GC alone (n=22), GC+TAC (n=23), and GC+MMF (±TAC) or GC+CY (n=19). The GC+TAC group demonstrated worse renal prognosis (log-rank P = 0.011). No differences in overall survival were observed among the groups.
Elderly LN in Japan is characterized by distinct clinicopathological features and poorer renal and survival outcomes compared with younger patients. Infection-related mortality was notably high, and GC+TAC regimens were associated with worse renal prognosis in elderly patients. These findings underscore the need for individualized therapeutic strategies and careful risk management in elderly LN.
