ISSN: 2251-8363    eISSN: 2251-8819  
J Nephropathol. 2014;3(3):115-120.
doi:10.12860/jnp.2014.22
PMID: 25093160
PMCID: PMC4119327

Scopus id: 84922602566

Original Article

Clinicopathological correlations in lupus nephritis; a single center experience

Hamid Nasri 1, Ali Ahmadi 2, Azar Baradaran 3, Ali Momeni 4, Parto Nasri 3, Saeed Mardani 4, Mahmood Rafieian-kopaei 5, Muhammed Mubarak 6 *

1 Department of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
4 Department of Nephrology, Shahrekord University of Medical Sciences, Shahrekord, Iran
5 Medical Plants Research Center, Shahrekord University of Medical Sciences, Sharhekord, Iran
6 Department of Histopathology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
Corresponding author: Prof. Muhammed Mubarak, Histopathology Department, Sindh Institute of Urology and Transplantation, Karachi-74200, Pakistan. Email: drmubaraksiut@yahoo.com

Abstract

Background: Renal biopsies play an important role in the diagnosis, management and prognosis of patients with lupus nephritis (LN).

Objectives: To determine the correlation between the pathological features of LN and the demographic, clinical and laboratory parameters.

Patients and Methods: This retrospective study was conducted from 2008 to 2014 on all consecutive cases of biopsy-proven LN at a nephropathology laboratory in Iran. The demographic, clinical and laboratory data were obtained from patients’ files and the biopsy findings from the original biopsy request forms.

Results: Of the 84 patients enrolled, 69 (82.2%) were females and 15 (17.8%) males. The mean age was 32.7±12 years. The mean serum creatinine was 1.5±0.94 mg/dl and the mean 24-h proteinuria, 1.6±1.9 grams. The majority of cases belonged to classes III and IV. The extracapillary proliferation was found in 42.86% of biopsies and endocapillary proliferation in 66.67% of biopsies. Patients of class IV-LN had a higher mean serum value of creatinine in comparison to class III-LN (2.19±1.09 versus 1.2±0.56 mg/dl; p= 0.0001). There was no significant difference of 24-h proteinuria between the two classes (p= 0.882). A significant association of serum creatinine with 24-h proteinuria (p= 0.041) was seen. Serum creatinine had significant positive correlation with activity percent (p< 0.001), and chronicity percent (p= 0.006), and also with proportion of glomeruli with crescents (p < 0.001). While there was a significant relationship of proteinuria with chronicity percent (p= 0.001), this association for activity percent was not significant (p= 0.094). Furthermore, the association of proteinuria with totally sclerotic glomeruli and proportion of crescents was not statistically significant (p= 0.186 and p= 0.0145 respectively).

Conclusions: In conclusion, the results from our study on biopsy-proven cases of LN largely concur with the previously reported studies from Iran and other parts of the world.

Implication for health policy/practice/research/medical education:

The pathological study of renal biopsies plays an important role in the diagnosis, prognosis and management of patients with lupus nephritis (LN). There is generally a good correlation between the clinical presentation and pathomorphological features on renal biopsies in patients with LN but this is not perfect. It is of utmost importance to correlate the clinical, serological and pathological data in patients with LN for their proper management and prognostication. Such correlative studies will also help better understand the pathophysiology of the renal involvement in this disease.

Please cite this paper as: Nasri H, Ahmadi A, Baradaran A, Momeni A, Nasri P, Mardani S, et al. Clinicopathological correlations in lupus nephritis; a single center experience. J Nephropathol. 2014; 3(3):115-120. DOI: 10.12860/jnp.2014.22

First name
 
Last name
 
Email address
 
Comments
 
Security code