The analysis indicated that age [OR 1.057 (1.020, 1.094), p = 0.002], hypertension [OR 2.340 (1.125, 4.867), p = 0.022], leukocyte count [OR 1.123 (1.001, 1.260), p = 0.048], and serum C4 levels [OR 1.057 (1.012, 1.105), p = 0.013] were associated with an increased risk of tubular atrophy events in patients with LN. Here, C4A is linked to lobular neoplasia.