In a new study, researchers have discovered a connection between inflammation in the areas of interstitial fibrosis and tubular atrophy (IFTA), a common pattern of kidney damage often seen in kidney disease, and renal outcomes. The researchers found that inflammation within scarred  kidney tissue, rather than scarring alone, is associated with poorer kidney function over time, as measured by poor glomerular filtration rate (GFR, measure of how well the kidneys are removing waste from the blood) in people with lupus nephritis, (LN, lupus-related kidney disease).

Using the Banff Classification of Allograft Pathology tool, researchers analyzed kidney biopsies of 124 people with LN. They found IFTA in 71% of the biopsies and IFTA inflammation (i-IFTA) in 86% of the cases. In individuals with moderate-to-severe IFTA, higher i-IFTA scores were independently associated with an increased risk of clinically meaningful GFR decline over follow up.

The researchers conclude that i-IFTA is a negative prognostic biomarker in LN, and its presence and severity may provide important prognostic information beyond traditional histologic features and should be routinely reported in biopsy assessments. More research is needed to investigate whether interstitial inflammation is a modifiable process and whether targeting it could improve chronic kidney disease progression in LN and other fibrotic kidney diseases. Learn more about lupus and the kidneys.

Read the study

Andrea Fava, MD, a Lupus Foundation of America (LFA) Gary S. Gilkeson Career Development Award (CDA) awardee and recent recipient of the LFA’s Mary Betty Stevens Young Investigator Prize lead this study.