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Objectives Mycophenolate mofetil (MMF) and intravenous cyclophosphamide (CYC) are recommended therapies for inducing treatment in Lupus Nephritis (LN), with evidence showing similar effectiveness in improving this condition. Due to limited local data, this study aims to compare the effectiveness of both therapies in Guatemala.Methods A retrospective review was conducted on the records of 138 patients diagnosed with LN between December 2008 and April 2025. Nine patients were excluded from the study due to the absence of information regarding their induction treatment. Consequently, 76 patients were treated with CYC and 54 with MMF for induction therapy. These patients are part of the ISLA cohort from Guatemala. A complete renal response (CRR) was defined as a 24-hour urinary protein (24 h-UTP) level below 0.5 grams. A partial renal response (PRR) was defined as a 50% or greater reduction in 24 h-UTP to a sub-nephrotic level. Those who do not achieve at least a PRR are considered non-responders. We utilized chi-square tests and Student’s t-tests for comparisons, and repeated measures ANOVA to assess changes in proteinuria from baseline to 12 months post initiation of induction.Results The demographic, clinical, maintenance, and current treatment characteristics of the CYC and MMF groups showed no significant differences, except for baseline proteinuria, which was higher in the CYC group (mean, 5.17 grams; p < 0.05). After 12 months post-induction, the CRR rates were 69.7% for CYC and 63% for MMF, while the PPR rates were 1.3% for CYC and 5.6% for MMF. Non-responders comprised 28.9% of the CYC group and 31.4% of the MMF group, with no significant differences between the two medications. There were also no differences in response rates at various time points (2, 4, 6, 8, 10, and 12 months). Both treatments showed significant improvements from baseline to 12 months, with p-values < 0.05. All patients completed the induction with no major adverse effects.Abstract PO:09:230 Table 1Comparisons of demographics, clinical, treatment, and response characteristics between MMF and CYC groups.Abstract PO:09:230 Figure 1–2Conclusions There were no significant differences between CYC and MMF use in our population, though CYC was more common in patients with high baseline proteinuria. The notable percentage of non-responders underscores the need for targeted therapies to effectively manage LN in our country.