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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.
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Abstract titles should be brief and reflect the content of the abstract.
Lupus nephritis (LN) is one of the most serious complication of Systemic lupus erythematosus. This study aims to compare the characteristics and outcomes of Early and Late LN patients in South Asian patients, where data remain limited.
Retrospective analysis of biopsy-proven lupus nephritis cases (2014–2024) was carried out from a South Asian tertiary centre. Exclusion criteria were age less than 18 years, less than one year follow up and non compliance to therapy. Patients were classified as early-onset (<1 year from SLE diagnosis) or late-onset (>1 year). Clinical, laboratory, and outcome data were reviewed; primary outcomes were End Stage Renal Disease(ESRD), mortality and time to remission. Statistical tests included t/Mann–Whitney U and Chi-square/Fisher’s exact, with significance at p<0.05.
Of 90 patients studied, 49 had early-onset and 41 had delayed-onset LN. The similar median age at LN diagnosis (23.5 years in early vs. 29 years in late, p=0.08 ) and predominance of females (79.6% vs. 90.2%, p=0.24) allowed for a more accurate comparison. Nephrotic syndrome was the most common presentation in both groups. Early-onset LN was associated with a higher frequency of systemic features such as fever, alopecia and abortion. Anti-dsDNA positivity was more frequent in early (33.3%) compared to late LN (12.5% ,p=0.04). Class IV nephritis predominated in both groups (early: 69.3%; delayed: 61.0%; p=0.44). Immunosuppressive regimens were comparable between the groups, though the use of cyclophosphamide was higher in early nephritis . There was no significant difference in the incidence of ESRD (20.4% in early vs. 31.7% in late, p=0.23) or mortality (12.2% vs. 19.5%, p=0.38). The mean time to remission was also similar (8.59 vs. 8.63 months; p=0.98).
Early
Late
P value
Median age at LN diagnosis
23.5
29
0.08
Female
79.6%
90.2%
0.24
Nephrotic syndrome
87.8%
0.99
Extra renal features
Fever
26.5%
14.6%
0.03
Rashes
22.4%
24.4%
0.83
Joint pain
20.4%
0.67
Neuro-lupus
18.4%
0.51
Abortion
14.3%
2.4%
0.04
Alopecia
12.2%
9.8%
Thrombotic events
4.9%
0.26
Hematological involvement
4.1%
7.3%
0.54
Lupus pneumonitis
2%
0.13
Laboratory Data
Highest serum creatinine (mg/dL)
2.91
3.70
0.34
Proteinuria (mg/day)
2331
2548
0.77
Hb <10 g/dL
97.9%
92.7%
0.33
Leukopenia (<4000/mm³)
10.2%
0.81
Lymphopenia ( <1000/mm3)
38.3%
34.15%
0.82
Thrombocytopenia ( <1 L/mm3)
22.45%
14.63%
0.58
Low Complement C3 (<90 mg/dL)
63.3%
73.2%
0.37
Low Complement C4 (<10 mg/dL)
4.08
0
Anti-dsDNA ≥60 IU/mL
33.3%
12.5%
Class
IV
34
25
0.17
V
9
10
0.79
III
7
6
1
Outcome
ESRD
31.7%
Mortality
19.5%
0.35
Time to remission (months)
8.59
8.63
0.98
This study underscores key differences between early and late lupus nephritis in a low middle income setting. Early LN was associated with more systemic features, elevated anti-dsDNA titres and greater cyclophosphamide use, suggesting a more aggressive immunologic phenotype. Despite this, comparable remission and mortality rates with late lupus indicate that timely recognition and treatment may mitigate long-term organ damage. Higher frequency of autoantibodies such as Anti-dsDNA in early LN suggests that autoantibody profiling may be a valuable diagnostic tool for timely intervention and optimization of patient care.
