Incidence, Prevalence, and Mortality of Lupus Nephritis: A Population-Based Study Over Four Decades—The Lupus Midwest Network (LUMEN)

Mehmet Hocaoglu, Maria O. Valenzuela-Almada, Jesse Y. Dabit, Shirley Ann Osei-Onomah, Baptiste Chevet, Rachel E. Giblon, Ladan Zand, Fernando C. Fervenza, Charles G. Helmick, Cynthia S. Crowson, Alí Duarte-García

Research output: Contribution to journalArticlepeer-review


Objectives: There is paucity of population-based studies investigating the epidemiology of lupus nephritis (LN) in the US and long-term secular trends of the disease and its outcomes. We aimed to examine the epidemiology of LN in a well-defined eight-county region in the US. Methods: Patients with incident LN between 1976 and 2018 (1976-2009 Olmsted County, 2010-2018 eight-county region) in Minnesota were identified. Age- and sex-specific incidence rates and point prevalence for four decades, adjusted to the projected 2000 US population, were reported. Standardized mortality ratios (SMR), survival rates, and time to end-stage renal disease (ESRD) were estimated. Results: There were 72 patients with incident LN between 1976–2018. Mean age at diagnosis was 38.4 years (SD 16.24), 76% were female, and 69% non-Hispanic White. Average annual LN incidence between 1976 and 2018 was 1 per 100,000 population (95%CI 0.8-1.3) and highest in the 30-39 age group. Between 1976–1989 and 2000–2018 periods, overall incidence of LN increased from 0.7 to 1.3 per 100,000, but this was not statistically significant. Estimated LN prevalence increased from 16.8 in 1985 to 21.2 per 100,000 in 2015. LN had an SMR of 6.33 (95% CI 3.81-9.89) with no improvement in mortality gap in the last four decades. At 10 years, survival was 70%, and 13% had ESRD. Conclusion: The incidence and prevalence of LN in this area increased in the last four decades. LN patients have poor outcomes with high rates of ESRD and mortality rates six times that of the general population. This article is protected by copyright. All rights reserved.

Original languageEnglish (US)
JournalArthritis and Rheumatology
StateAccepted/In press - 2023

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology


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