RT Journal Article SR Electronic T1 P189 Antiphospholipid antibodies and vascular renal lesions as prognostic factors in lupus nephritis JF Lupus Science & Medicine JO Lupus Sci Med FD Lupus Foundation of America SP A122 OP A122 DO 10.1136/lupus-2020-eurolupus.231 VO 7 IS Suppl 1 A1 Paglionico, Annamaria A1 Varriano, Valentina A1 Petricca, Luca A1 Marioa, Clara Di A1 Gigante, Maria Rita A1 Tanti, Giacomo A1 Tolusso, Barbara A1 Ferraccioli, Gianfranco A1 Gremese, Elisa YR 2020 UL http://lupus.bmj.com/content/7/Suppl_1/A122.1.abstract AB Purpose To determine the role of antiphospholipid antibodies (aPL) and vascular renal lesions on renal prognosis, in terms of time to achieve remission, number of renal flares and development of chronic renal damage in patients with lupus nephritis (LN).Methods 91 consecutive LN patients have been evaluated and the follow-up data have been collected at the baseline and at 6, 12, 24 months and at the last follow-up visit. Histopathological data of 41 patients were evaluated according to the 2016 revision of ISN/RPS classification.Results Among the 91 LN patients, 31(34.1%) were aPL positive (aPL+), 10(32.2%) of them were affected by Antiphospholipid Antibodies Syndrome (APS), 53.3% showed a single aPL positivity, 23.1% double aPL positivity and 15.4% triple aPL positivity. At the last follow up visit a significant higher number of aPL+ patients showed a persistent complement consumption than aPL negative (aPL-) patients (p=0.001). We observed that aPL- patients showed a remission achievement time slightly earlier than aPL+ patients (13.6±1.0 months vs 16.5±1.5 months; log-rank test: p=0.06, Breslow test: p=0.08) and as expected, patients with a persistent complement consumption achieve remission later (18.2 ±1.5 months vs 13.0±1 months; log-rank test: p=0.002, Breslow test: p=0.003). Furthermore at the last follow up, a significant higher percentage of aPL+ patients developed persistent proteinuria (p=0.02) and chronic renal failure (p=0.04). Considering histolopathologic features we didn’t observe significant differences between aPL+ and aPL- patients but we found two typical vascular lesions (mesangiolysis and vascular thrombi) only in aPL+ patients.Conclusion Apl positivity is a predictor of worse renal outcome but in our cohort we didn’t find an association between aPL positivity and vascular renal lesions at renal biopsy. The worse renal outcome and the late time to achieve remission in aPL+ group can be related to a cumulative vascular damage over time.