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PO:09:245 Risk of severe infection in lupus nephritis patients with chronic kidney disease & comparison to ANCA vasculitis-patients: a nationwide study

lupusscimed · 2026-03-01 · canonical JSON source

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Objectives Both lupus nephritis (LN) and ANCA-vasculitis are associated with an increased infection-risk, especially in the setting of chronic kidney disease (CKD). However, comparative data between these two conditions remain limited. Identifying CKD-aetiologies with a particularly high risk of infection is crucial, so the aim of this study was to compare the risk of severe infection between LN-CKD and ANCA-CKD.Methods Using data from the Swedish Renal Registry (2006-2021), we included patients with CKD due to LN or ANCA vasculitis. Poisson models were used to calculate adjusted incidence rate ratios (aIRR) of all-cause infection- hospitalization (a composite of pulmonary, gastrointestinal, genitourinary infection, sepsis, infection on other sites). Cox models were used to estimate adjusted hazard ratios (aHR) of death due to infection, and of infection-related hospitalization.Results We identified 317 patients with LN-CKD and 783 patients with ANCA-CKD. At baseline, patients with LN-CKD were younger (61 vs 71 years), had higher eGFR (30 vs 26 mL/min/1.73m 2) and received less steroids (60% vs 66%) but more other immunosuppressive therapy (49% vs 40%) than ANCA-CKD.During a median follow-up of 2.8 [1.2; 5.0] years, 393 patients (36%) had a least one infection-related hospitalization and 80 patients (7%) died due to infection.Incidence rates of all-cause infection-related hospitalization were 25 per 100-PY in LN-CKD and 28 per 100-PY in ANCA-CKD. Respiratory tract was the most common infection site in both LN-CKD and ANCA-CKD.When accounting for all hospitalizations occurring during follow-up, LN-CKD exhibited a higher adjusted incidence rate of infection-related hospitalization than ANCA-CKD (aIRR 1.28 [1.12-1.46]) (figure A).In the time-to- first event analysis, LN-CKD had a similar rate of death due to infection (aHR: 1.22 [0.72-2.04]) but tended to have a higher rate of infection-related hospitalization (aHR: 1.22 [0.98-1.52]).After further adjustment for steroids, LN-CKD exhibited a higher risk of infection-related hospitalization than ANCA-CKD (aHR: 1.25 [1.00-1.56]) (figure B).Abstract PO:09:245 Figure 1Conclusions Although the risk of infection-related death was similar between the two groups, patients with LN-CKD exhibited a higher risk of infection-related hospitalization than ANCA-CKD. Our study emphasizes the need for infection prevention in patients with LN-CKD.