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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.
Systemic lupus erythematosus–associated thrombotic microangiopathy (SLE-TMA) is a rare but life-threatening complication with high mortality and risk of progression to end-stage kidney disease (ESKD). Data on prognostic factors and treatment outcomes remain limited. This systematic review aimed to determine the prevalence of a composite outcome—mortality, ESKD, or lack of renal remission—in patients with SLE-TMA and to identify associated risk factors and treatment effects.
A systematic search of MEDLINE, EMBASE, and the Cochrane Database was conducted from inception through February 2025. Studies reporting mortality, ESKD, or renal remission in SLE patients with TMA—including atypical hemolytic uremic syndrome (aHUS)/unspecified TMA, thrombotic thrombocytopenic purpura (TTP), or antiphospholipid syndrome (APS)–associated TMA—were included without language restriction. The protocol was registered in PROSPERO (CRD42025649286).
From 2,726 database records and 77 manually identified articles, 169 studies were included: 38 retrospective cohorts, 1 prospective cohort, 1 cross-sectional study, and 129 case reports or series, comprising 1,204 patients. The median follow-up time was 12 months (IQR, 1.6–36). Most patients were female (80%) with a mean age of 28 ± 15 years; 63% had concurrent lupus nephritis. The predominant TMA subtypes were aHUS/unspecified (70%), APS (15%), and TTP (15%). Severe kidney impairment requiring dialysis occurred in 40% of total cohort. Baseline laboratory values included serum creatinine 2.5 ± 2.5 mg/dL, proteinuria 3.6 ± 5.4 g/day, hemoglobin 8.0 ± 2.2 g/dL, and platelet count 85 ± 99 ×10⁹/L. Treatment modalities included immunosuppressive therapy (88%), plasma exchange or infusion (48%), rituximab (9.5%), IVIg (6.4%), and C5 inhibitors (6%). The composite outcome occurred in 483 of 1,204 patients (40.1%); mortality in 223 of 1168 (19%) [50% of mortality occurred within 1 year]; ESKD in 205 of 780 (26.3%); and lack of renal remission in 272 of 633 (43.0%). Sensitivity analysis demonstrated that C5 inhibitor use was associated with lower mortality (p = 0.013) but higher proportion of of ESKD among survivors (p = 0.028). However, patients who received C5 inhibitor have higher rate of dialysis among presentation (58.1% vs. 35.2%, p=0.005). Other treatments showed no different between outcomes.
SLE-TMA is associated with high mortality and kidney failure despite intensive therapy. C5 inhibitor may improve survival outcome. However, rate of ESKD at last follow-up is higher in C5 inhibitor user, likely due to more dialysis upon presentation in C5 inhibitor group. Prospective studies are warranted to clarify prognostic factors and optimize management strategies.
