Compared with patients with no or mild interstitial fibrosis and tubular atrophy (IFTA), patients with moderate-to-severe IFTA have worse kidney survival, according to a study published in Lupus. Additionally, those with class IV lupus nephritis (LN) and fibrous crescents had worse kidney survival compared with those without IV LN and fibrous crescents, respectively. To identify independent predictors of ESKD, researchers conducted multivariable Cox proportional hazard regression and competing-risk analyses. During a median time of 4.2 (2.0-55.2) months after biopsy, 20% of patients progressed to ESKD. Tubulointerstitial inflammation was present in 72.3% of biopsies, while IFTA was observed in 34.7% of biopsies. In both the Kaplan-Meier (P=0.018) and the competing-risk analyses (P=0.017), patients with moderate-to-severe IFTA
had worse kidney survival than those with no or mild IFTA. Patients with class IV±V LN had worse kidney survival than those with non-class IV LN by the Kaplan-Meier method (P=0.050), but not in the competing-risk analysis (P=0.154).