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Class V lupus nephritis: a clinicopathologic study in 152 patients
Qiang Chen1, Zhihong Liu, Weixin Hu
1Department of Nephrology, Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, China. qiangchen@vip.sina.com
Journal of Nephrology
|March 26, 2003
Summary
Class Vb lupus nephritis (LN) shows more severe kidney injury and worse prognosis than Class Va. Class Vb patients are more prone to progress to Class IV LN.
Area of Science:
- Nephrology
- Immunology
- Internal Medicine
Background:
- Class V lupus nephritis (LN) is classified into subgroups Va and Vb.
- Clinical differences between Class V lupus nephritis subgroups are not well-established.
Purpose of the Study:
- To compare clinical characteristics, serologic results, and prognosis between Class Va and Class Vb lupus nephritis.
- To investigate the progression of Class V lupus nephritis to Class IV.
Main Methods:
- 152 patients with Class V lupus nephritis (61 Va, 91 Vb) and 488 with Class IV LN were analyzed.
- Clinical manifestations, serologic data, and renal biopsy findings were compared.
- Long-term outcomes including renal function and progression to end-stage renal disease (ESRD) were assessed.
Main Results:
- Class Vb LN patients exhibited higher rates of hypertension, anemia, hematuria, and renal insufficiency compared to Class Va.
- Positive anti-dsDNA antibody and hypocomplementemia were more frequent in Class Vb.
- Class Vb patients showed a greater tendency to transform to Class IV LN and had a higher risk of progressing to ESRD.
Conclusions:
- Class Vb lupus nephritis presents with more severe renal and extrarenal manifestations than Class Va.
- Class Vb lupus nephritis carries a poorer prognosis and a higher likelihood of progression to Class IV LN.