X2O ❓What about renal transplantation in this group of patients? 👉Two patients received renal transplantation during 2 years follow-up 👉One received after renal transplantation at 4 years follow -up #IPNAJC

Welcome @stepsofgrace17 #IPNAJC

X3A 🎯Complete remission (CR) at 24m F/U was in 52.9% (of 382)⏭️This is greater than earlier studies (38% at 12m by Suhlrie et al) pubmed.ncbi.nlm.nih.gov/32193650/ Adult studies👉shown those who have achieved either partial or CR at 24m had a ⏬Risk of future renal failure or mortality

X3B In both adult & pediatric studies, MMF was found as effective as IV cyclophosphamide in inducing remission. #IPNAJC

X3C 🔑Findings: 🎯Mean age at onset: 11y 9m [72.8%👧] 🎯At 24m F/U 👉57% CR 👉34% PR 👉89 of 351 stable CR at 6-24m F/U 🎯eGFR ≥90 ml/min @ diagnosis & biopsy class III👉 Predictive of kidney remission ⛔️difference ~ MMF & Cyclophosphamide (maintain stable remission) #IPNAJC

X3D What about inflammatory markers for prognostication? 🎯Higher dsDNA at diagnosis ē more stable remission, likely due to more aggressive treatment and follow up? 🎯Low C3/C4 at diagnosis associated ē proliferative lesions on biopsy pubmed.ncbi.nlm.nih.gov/36688943/ #IPNAJC

X3E 🔭Predictive factors⏩Long-term remission 🎯In Children & adults 👉eGFR @ onset 👉LN class 👉Nephrotic proteinuria Euro-LN Trial👉Improvement in renal impairment & proteinuria (1g/day) @ 6m (Best predictor of long-term kidney outcome) pubmed.ncbi.nlm.nih.gov/19155235/ #IPNAJC

What is your take-home message? ❓Will you change your induction regimen for LN based on this paper? ❓How can we do better as pediatric nephrologists to achieve early complete remission in LN? ❓Is there more we can do to obtain an earlier diagnosis of LN? #IPNAJC

See u in 3m ē new #pedneph topic 📩Leave your suggestion & comment 👉If you would like to contribute #IPNAJC, pls DM @ipnajc 👉Signup for newsletter theipna.org/journalclub/ Sincerely: Shweta Shah M.D; FASN Sudha Mannemuddhu, MD, FAAP, FASN, FNKF Swasti Chaturvedi M Abdul Qader🇧🇩 Franklin Loachamin @stepsofgrace17 #IPNAJC

🌟Join us for the next IPNA Journal Club @ipnajc 🗓️July 24, 2024 ⏰ 11am ET/ 5pm CEST/9pm IST 📍Zoom 🆕 🆓Registration: tinyurl.com/mwfb3xpu #pedneph #IPNAJC #learning

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