BRIEF RESEARCH REPORT article
Front. Pediatr.
Sec. Pediatric Rheumatology
This article is part of the Research TopicNew Insights in Pediatric Rheumatology: Advances in Diagnosis and TreatmentView all 9 articles
Clinical, Laboratory, and Histopathological Characteristics of Pediatric Lupus Nephritis: A Retrospective Study in a National Referral Center in Mexico
Provisionally accepted
- 1Federico Gómez Children's Hospital, Mexico City, Mexico
- 2Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
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Background: Pediatric lupus nephritis (LN) remains a major cause of morbidity and mortality, yet data from Latin American populations are limited. This study aimed to describe the clinical, laboratory, and histopathological characteristics of pediatric LN and identify prognostic factors associated with renal replacement therapy (RRT). Methods: We conducted a retrospective cross-sectional study including patients <18 years of age with LN diagnosed between 2020 and 2024 at a national referral center in Mexico. Demographic, clinical, immunological, histopathological, and therapeutic variables at diagnosis were analyzed. Multivariable logistic regression was performed to identify predictors of RRT. Results: Eighty patients were included (83% female; mean age 15.1 ± 2.8 years). Median proteinuria was 41 mg/m²/h; hematuria and leukocyturia were present in 46% and 26% of patients, respectively. All patients were ANA positive, with frequent hypocomplementemia and elevated anti–double-stranded DNA titers. Among biopsied patients, class IV was the most common histological subtype (60%). Proliferative forms were associated with reduced glomerular filtration rate (<90 mL/min/1.73 m²; p = 0.012) and higher activity index scores (p = 0.04), while chronicity indices were low. Fifteen patients (18.8%) required RRT, and mortality was 6.25%. In multivariable analysis, hypoalbuminemia (<2.5 g/dL) was independently associated with RRT (OR 6.04; 95% CI 1.33–27.50; p = 0.020). Conclusions: This study represents one of the largest pediatric LN cohorts reported from Mexico. Proliferative forms were associated with greater inflammatory activity and impaired renal function at diagnosis. Hypoalbuminemia emerged as a simple and accessible biomarker for early risk stratification of severe renal outcomes.
Keywords: Hypoalbuminemia, Lupus Nephritis, Pediatric systemic lupus erythematosus, Prognostic biomarkers, Renal Replacement Therapy
Received: 10 Nov 2025; Accepted: 26 Jan 2026.
Copyright: © 2026 Menchaca Aguayo, Faugier Fuentes, Bernabe Jimenez and Chacón Abril. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Enrique Faugier Fuentes
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