According to the REIN registry, lupus nephritis patients who initiate dialysis due to chronic kidney disease progression still experience flares, with the highest rate occurring during the first year. Off-treatment rates increased from 67.7% at dialysis initiation to 83.4% at 36 months before stabilizing. Patients younger than 42 years were less likely to be off treatment at any time point. By 12 months, 51.6% of patients had a non-severe lupus flare, and 11.6% had a severe lupus flare. Additionally, hospitalization rates for cardiovascular events and infections were high. By 12 months, 19.0% of patients had received a kidney transplant, whereas 4.8% had died. The investigators recommend follow-up care by lupus specialists after dialysis initiation to manage potentially life-threatening lupus flares.

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