Repeat kidney biopsy in pediatric lupus nephritis: an analysis of associated clinical-pathological features and outcomes

Background: The utility of repeat kidney biopsy in pediatric lupus nephritis (LN) remains debated. This study aims to evaluate pathological evolution, therapeutic implications, and prognostic impact of repeat biopsies in children with LN. Methods: < 0.05 considered significant. Results: > 0.05). Conclusion: Repeat kidney biopsy detects pathological progression (e.g., increased chronicity) and guides treatment modifications in over 60% of pediatric LN cases. However, pathological class change alone does not dictate short-term outcomes, highlighting initial treatment response as a stronger prognostic indicator. Individualized use of repeat biopsies is recommended for children with proteinuria relapse to optimize management while mitigating procedural invasiveness.