Abstract: Ｏｂｊｅｃｔｉｖｅ：To investigate the clinical characteristics and prognosis of critical patients with active lupus nephritis (LN).
Ｍｅｔｈｏｄｏｌｏｇｙ：A total of 450 LN patients admitted to the renal intensive care unit (ICU) of the National Clinical Research Center of Kidney Diseases, from January 2010 to December 2019 were included in the study. The etiology, organ involvement and prognosis of patients were retrospectively analyzed.
Ｒｅｓｕｌｔｓ：Among the 450 LN patients, 168 (373％) were complicated with infection. The most common involved organ injury was kidney (100％), followed by central nervous system (198％), heart (158％), gastrointestinal tract (87％), lung(47％) and hematology (47％).Multiple organ involvement accounted for 42％. 79 patients (176％) were diagnosed with thrombotic microangiopathy (TMA), and the incidence of TMA was higher in those with multiple organ (368％) and cardiac involvement (351％).246 patients (547％) received renal replacement therapy and 533％ of them recovered. The 28day and 3month postICU discharge mortality rate was 76％ and 109％. The mortality rate of patients with infection was significantly higher than other (159％ vs 79％, P=0011). The 3month renal survival rate was 723％, and the renal survival of patients with TMA was significantly lower than the others(618％ vs 746％, P=0025). COX multivariate analysis showed that infection, central nervous system injury and multiple organ involvement were independent risk factors for 3month survival. Age and hematological injury were independent risk factors of poor renal survival.
Ｃｏｎｃｌｕｓｉｏｎ：Critical patients with active LN who have a high incidence of TMA and infection were often complicated with various organ involvement, and had poor patient and renal survival. Early identification and effective treatment are essential to improve the prognosis.

Key words: lupus nephritis, intensive care unit, clinical characteristic, prognosis