Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices

Chronic tubulointerstitial changes, particularly tubular atrophy, are a stronger predictor of longterm kidney function than glomerular findings or AI scores. These findings highlight the prognostic value of NIH-modified CI and the importance of MMF in maintenance therapy. The early identification of chronic lesions on biopsy may guide therapeutic decisions aimed at preserving kidney function and improving long-term outcomes in patients with cLN.