RENAL BIOPSY DATABASES IN ADVANCING CLINICAL RESEARCH: CARDIOVASCULAR RISK ASSESSMENT IN LUPUS NEPHRITIS
Thomas-Molnár Adél
Theoretical and Translational Medicine Division
Dr. Kellermayer Miklós
SE Belgyógyászati és Onkológiai Klinika tanterme
2025-10-08 15:30:00
Translational kidney research and organ transplantation
Dr. Zsembery Ákos
Dr. Ledó Nóra
Dr. Kempler Miklós
Dr. Markóth Csilla
Dr. Tory Kálmán
Dr. Mikes Bálint
Dr. Haris Ágnes
Background: Renal biopsy registries are crucial for tracking disease trends, optimizing resources, and advancing research.
Objectives: Our study aimed to establish a standardized renal biopsy database to analyze Hungarian trends in renal disease distribution and temporal changes. We also investigated cardiovascular (CV) risk in lupus nephritis patients, a cohort requiring mandatory renal biopsy.
Methods: We retrospectively analyzed 2140 renal biopsies (2006–2020) from 28 nephrology centers in Northern and Central Hungary, using standardized diagnostic criteria. Lupus nephritis patients (biopsied 2005–2020) were further examined for clinical and pathological data. Major adverse cardiovascular events (MACE) included myocardial infarction, heart failure hospitalization, stroke, coronary revascularization, and cardiovascular death. Statistical analysis was conducted with IBM SPSS v28 and GraphPad Prism v9.0.
Results: IgA nephropathy was the most common diagnosis, followed by focal segmental glomerulosclerosis and membranous nephropathy. Disease distribution varied by age and sex: diabetic and membranous nephropathy were more common in men, while lupus nephritis and microscopic polyangiitis predominated in women. ANCA-associated vasculitis increased over time. Among 91 lupus nephritis patients, 15.38% experienced MACE over a mean follow-up of 62 ± 48 months. Older age, higher neutrophil counts, and lower diastolic blood pressure were independent risk factors. We introduced the CANDE model (Cardiovascular Risk Based on Age, Neutrophil Count, and Diastolic Blood Pressure Estimation Score) to predict MACE risk. 1 point increase in CANDE correlated with a 13.7% higher relative MACE risk. The model demonstrated high sensitivity (78.6%) and specificity (81.9%).
Conclusions: Our findings highlight evolving renal disease patterns in Hungary and emphasize the importance of CV risk assessment in lupus nephritis patients. The CANDE model provides a simple, effective tool for early risk prediction, supporting timely interventions and improved patient outcomes.
