Lupus nephritis in Lebanon

Area of Science:

• Nephrology
• Rheumatology
• Pathology

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organs, including the kidneys.
• Lupus nephritis, a serious complication of SLE, significantly impacts patient prognosis.
• Understanding the clinicopathological characteristics and treatment outcomes of lupus nephritis is crucial for effective patient management.

Purpose of the Study:

• To retrospectively analyze the clinicopathological characteristics of lupus nephritis in Lebanese patients.
• To compare the prevalence of lupus nephritis histological classes in Lebanon with other populations.
• To evaluate treatment strategies and patient outcomes in this cohort.

Main Methods:

• Retrospective review of 50 patients with lupus nephritis who underwent kidney biopsy at American University of Beirut Medical Center (1979-1999).
• Histopathological assessment of renal biopsies using the World Health Organization (WHO) classification.
• Analysis of patient demographics, treatment regimens (prednisone, cyclophosphamide, azathioprine, etc.), and follow-up data.

Main Results:

• Diffuse proliferative lupus nephritis (class IV, 38%) was the most common histopathological type, unlike class III prevalent in other Arab nations.
• The patient cohort comprised 43 females and seven males, with a median age of 24 years.
• At follow-up (median 5 years), 54% of patients had controlled disease, while 11% required chronic hemodialysis and 13% died.

Conclusions:

• Diffuse proliferative lupus nephritis (class IV) is the predominant form in Lebanon, aligning with international data but differing from regional trends.
• Treatment involved various immunosuppressants, with a significant proportion achieving disease control, though some progressed to end-stage renal disease or mortality.
• Further research is warranted to optimize treatment strategies for lupus nephritis in diverse populations.