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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
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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.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
To date, lupus nephritis (LN) remains an important cause of morbidity and mortality in patients with systemic lupus erythematosus and could result in progressive chronic kidney disease and dialysis. Immunosuppressive therapy (IS) in various regimens is the mainstay in preventing these adverse outcomes. However, treatment- or disease-related infections are also important leading causes of mortality. Moreover, current prophylaxis regimens lack a standard consensus. Our study aims to identify risk or protective factors of these infections, to further guide IS decision in LN.
Medical records of patients with biopsy proven LN in our hospital between 1 January 2017 to 31 December 2021 were retrospectively reviewed. Those with extra-renal indication for IS and with incomplete data were excluded. Various baseline characteristics, IS, prophylaxis regimens, and outcomes were collected and analyzed with binary logistic regression for the occurrence of any hospitalized infection within 2 years after the diagnosis.
233 patients (mean age36±12 years, 88%female) were included. Thirty-nine infectious events occurred (pathogens: 14 gram-negative bacteria, 5 gram-positive bacteria, 3 tuberculous mycobacteria, 9 any viruses, 2 fungus). Male gender, diabetes mellitus, lowered baseline hemoglobin, lowered baseline plasma bicarbonate, and higher prednisolone dose significantly increased risk of infection. Prescription of trimethoprim/sulfamethoxazole (TMP/SMX) only in daily double strength dose, but not the single strength dose and no prophylaxis, reduced the infectious risk even after multivariate analysis (Table 1). Two cases had pneumocystis pneumonia (PCP), both did not receive medical prophylaxis, occurred. Three patients had herpes infection (skin infection, gingivostomatitis, and meningitis) with no to 400-mg acyclovir prophylaxis. Four infection-related deaths occurred (pathogen: Salmonella, Escherichia coli, tuberculosis, and fungi), in whom IS regimens included only prednisolone to steroid combined with mycophenolate mofetil 2000mg/day and hydroxychloroquine.
Table 1 Unadjusted and adjusted odds ratios of various factors for hospitalized infection in lupus nephritis. The adjusted odds ratio accounted for significant factors from literature review and some of those of the present study, which included age, male gender, diabetes status, body mass index, baseline hemoglobin, prednisolone use, and trimethoprim/sulfamethoxazole double strength use. Unlike this higher dose, the use of any dose of any dose of trimethoprim/sulfamethoxazole (single strength or double strength) was not a significantly protective factor for hospitalized infection, even in adjusted analysis.
Prescribing IS, especially higher dose prednisolone, in LN patients with risk factors for hospitalized infection requires careful decision and vigilant monitoring to balance risk-benefit for the best outcome. In addition to PCP prophylaxis, TMP/SMX in daily double strength dose could prevent overall infective complications.
