Abstract: Objective To study the relationship between intestinal microflora and clinicopathological features and long-term renal survival in patients with lupus nephritis (LN).Methods The patients who were diagnosed as LN in our hospital from August 2017 to August 2018 were selected as the LN group,and the patients who were diagnosed as systemic lupus erythematosus (SLE) in the same period and had normal renal function were selected as the SLE group,and the healthy persons who were examined as the control group.The contents of intestinal microflora in the feces was measured,the influencing factors of end-stage renal disease (ESRD) in LN patients were analyzed by COX regression model,and the predictive value of intestinal microflora to ESRD in LN patients was analyzed by ROC curve.Results The content of bifidobacteria and lactobacilli in the feces in the LN group were significantly lower than those in the SLE group and control group,and the content of Escherichia coli was significantly higher than that in the SLE group and control group (P<0.05).Compared with patients without arthritis,and with normal serum creatinine (SCr) and non-severe proteinuria and Ⅲ/Ⅲ+V stage in the LN group,the content of bifidobacteria and lactobacilli in the feces significantly decreased,the content of escherichia coli significantly increased in the patients with arthritis,increased SCr,severe proteinuria and Ⅳ/Ⅳ+V stage in the LN group (P<0.05).The COX regression analysis showed that the course of LN,SCr,pathological type and content of bifidobacteria were the influencing factors of ESRD in LN patients (P<0.05); ROC curve analysis showed that the content of bifidobacteria in the feces of LN patients had predictive value for ESRD.Conclusions The disturbance of intestinal flora in LN patients is related to clinicopathological features,and the decrease of bifidobacteria in intestinal flora is related to the occurrence of ESRD,and has predictive value for ESRD.