{ "abstract": "Purpose: A proportion of patients with systemic lupus erythematosus (SLE) present with subclinical low-level proteinuria at initial diagnosis that does not meet the formal classification criteria for lupus nephritis (LN). This study aimed to investigate the association between low-level proteinuria at SLE onset and the risk of developing proteinuria-predominant LN. Patients and methods: This was a retrospective cohort study using medical records of patients newly diagnosed with SLE from Fujian Medical University Union Hospital between December and March. Inclusion required urine dipstick proteinuria ≤2+; if quantified, protein excretion <500 mg/24h (by the urine protein-to-creatinine ratio [UPCR] or 24-hour proteinuria). Demographic, clinical, and laboratory data were collected at the time of initial diagnosis, as well as urinalysis, urine sediment, UPCR, and 24-hour proteinuria during follow-up, where available. The association between various baseline variables and the subsequent development of proteinuria-predominant LN was analyzed using a Cox proportional hazards model. Results: Of 330 patients screened, 297 were eligible for inclusion in the final analysis, of whom 85 patients had low-level proteinuria at the initial diagnosis. According to multivariable-adjusted models, low-level proteinuria significantly increased the risk of proteinuria-predominant LN (P < 0.001, hazard ratio[HR] = 3.355, 95% confidence interval [CI]: 1.6646.765), as did male sex (P = 0.001, HR = 3.178, 95% CI: 1.563–6.460). Conclusion: This study highlights that SLE patients with low-level proteinuria at initial diagnosis may require enhanced monitoring for LN, enabling early detection. Future studies are needed to determine the necessity of early intervention.", "abstract_shown": true, "affiliations": [ "Department of Rheumatology, Sanming First Hospital Affiliated to Fujian Medical University, Sanming, China.", "Department of Rheumatology, Fujian Medical University Union Hospital, Fuzhou, China.", "Department of Rheumatology, Nanping First Hospital Affiliated to Fujian Medical University, Nanping, China.", "Department of Nephrology, Fujian Medical University Union Hospital, Fuzhou, China.", "Fujian Institute of Clinical Immunology, Fujian Medical University Union Hospital, Fuzhou, China." ], "article_type": "Research Article", "arxiv": null, "author_total": 9, "authors": [ { "affs": [ 0, 1 ], "name": "Minghui Song" }, { "affs": [ 1 ], "name": "Guolong Xu" }, { "affs": [ 1 ], "name": "Fengxian Xu" }, { "affs": [ 2 ], "name": "Shengkai Zhang" }, { "affs": [ 2 ], "name": "Qinqin Wang" }, { "affs": [ 2 ], "name": "Wenjing Xue" }, { "affs": [ 1 ], "name": "Ruiying Chen" }, { "affs": [ 3, 4 ], "name": "Lixin Wei" }, { "affs": [ 1, 2, 4 ], "name": "He-Jun Li", "orcid": "0000-0001-9179-8887" } ], "bibtex": "https://research.draconitic.com/paper/2d6q0vfxtt4ap.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0361288", "fulltext_url": "https://europepmc.org/articles/PMC13718944", "id": "2d6q0vfxtt4ap", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0361288", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Anatomy" ], [ "heading", "Autoimmune Diseases" ], [ "heading", "Biology and Life Sciences" ], [ "heading", "Body Fluids" ], [ "heading", "Clinical Immunology" ], [ "heading", "Clinical Medicine" ], [ "heading", "Diagnostic Medicine" ], [ "heading", "Drugs" ], [ "heading", "Epidemiology" ], [ "heading", "Immunology" ], [ "heading", "Immunosuppressives" ], [ "heading", "Kidneys" ], [ "heading", "Lupus Erythematosus" ], [ "heading", "Lupus Nephritis" ], [ "heading", "Medical Risk Factors" ], [ "heading", "Medicine and Health Sciences" ], [ "heading", "Pharmacology" ], [ "heading", "Physiology" ], [ "heading", "Proteinuria" ], [ "heading", "Renal System" ], [ "heading", "Research Article" ], [ "heading", "Rheumatology" ], [ "heading", "Signs and Symptoms" ], [ "heading", "Systemic Lupus Erythematosus" ], [ "heading", "Urine" ], [ "plos", "/Biology and life sciences/Anatomy/Body fluids/Urine" ], [ "plos", "/Biology and life sciences/Anatomy/Renal system/Kidneys" ], [ "plos", "/Biology and life sciences/Immunology/Clinical immunology/Autoimmune diseases/Lupus erythematosus/Systemic lupus erythematosus" ], [ "plos", "/Biology and life sciences/Immunology/Clinical immunology/Autoimmune diseases/Lupus nephritis" ], [ "plos", "/Biology and life sciences/Physiology/Body fluids/Urine" ], [ "plos", "/Medicine and health sciences/Anatomy/Body fluids/Urine" ], [ "plos", "/Medicine and health sciences/Anatomy/Renal system/Kidneys" ], [ "plos", "/Medicine and health sciences/Clinical medicine/Clinical immunology/Autoimmune diseases/Lupus erythematosus/Systemic lupus erythematosus" ], [ "plos", "/Medicine and health sciences/Clinical medicine/Clinical immunology/Autoimmune diseases/Lupus nephritis" ], [ "plos", "/Medicine and health sciences/Clinical medicine/Signs and symptoms/Proteinuria" ], [ "plos", "/Medicine and health sciences/Diagnostic medicine" ], [ "plos", "/Medicine and health sciences/Epidemiology/Medical risk factors" ], [ "plos", "/Medicine and health sciences/Immunology/Clinical immunology/Autoimmune diseases/Lupus erythematosus/Systemic lupus erythematosus" ], [ "plos", "/Medicine and health sciences/Immunology/Clinical immunology/Autoimmune diseases/Lupus nephritis" ], [ "plos", "/Medicine and health sciences/Pharmacology/Drugs/Immunosuppressives" ], [ "plos", "/Medicine and health sciences/Rheumatology/Systemic lupus erythematosus" ] ], "openalex": null, "pdf_url": "https://europepmc.org/articles/PMC13718944?pdf=render", "pmcid": "PMC13718944", "pmid": "42956009", "published": "2026-10-29", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/2d6q0vfxtt4ap.ris", "sources": [ { "first_seen": "2026-10-30T12:17:17Z", "native_id": "10.1371/journal.pone.0361288", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0361288" }, { "first_seen": "2026-11-01T00:20:36Z", "native_id": "MED:42956009", "source": "europepmc", "url": "https://europepmc.org/article/MED/42956009" }, { "first_seen": "2026-11-02T12:22:52Z", "native_id": "PMC13718944", "source": "pmc", "url": "https://doi.org/10.1371/journal.pone.0361288" } ], "subjects": [ { "field": "biology", "origin": "plos:immunology", "subfield": "immunology" }, { "field": "medicine", "origin": "heading:Epidemiology", "subfield": "epidemiology-public-health" }, { "field": "medicine", "origin": "heading:Pharmacology", "subfield": "pharmacology-toxicology" }, { "field": "medicine", "origin": "plos:anatomy", "subfield": "physiology" } ], "title": "Low-level proteinuria at the initial diagnosis of systemic lupus erythematosus significantly increases the risk of developing proteinuria-predominant lupus nephritis", "title_text": "Low-level proteinuria at the initial diagnosis of systemic lupus erythematosus significantly increases the risk of developing proteinuria-predominant lupus nephritis", "type": "peer-reviewed", "updated_at": "2026-11-02T12:22:52Z", "url": "https://research.draconitic.com/paper/2d6q0vfxtt4ap", "venue": "PLOS One", "versions": [] }