Poor Renal Outcomes in Lupus Podocytopathy in a Predominantly African American Cohort (ACR Convergence 2026) - Sep 8, 2026 - Abstract #2266; Pres time: Nov 10, 2026; 10:30 AM - 12:30 PM; Location: WB1&2; In Person; "Despite intensive therapy (corticosteroids, hydroxychloroquine, and mycophenolate in most; rituximab, cyclophosphamide, voclosporin, belimumab, or anifrolumab in 13/16), among 15 patients with follow-up only 6 (40%) achieved complete renal response and 8 (53%) had none; 3 (20%) required renal replacement therapy and 5 (33%) died. In this largest predominantly African American LP cohort, LP behaved as an aggressive, treatment-refractory disease – reaching kidney failure and death despite intensive immunosuppression and shorter follow-up than comparator cohorts. Two APOL1 high-risk alleles in half of genotyped patients, predominantly in FSGS/collapsing lesions, suggest a distinct, higher-risk phenotype. These findings challenge the view of LP as a uniformly steroid-responsive, benign entity and support APOL1 genotyping, close monitoring, and individualized treatment in Black patients with LP."
Focal Segmental Glomerulosclerosis • Glomerulonephritis • Immunology • Inflammatory Arthritis • Lupus • Lupus Nephritis • Nephrology • Renal Disease
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