Lupus nephritis in Iranian children: a review of 60 patients

In this first study of lupus nephritis (LN) in Iranian children, we report their presentation and outcome.

A retrospective cohort study was conducted on 60 prepubertal (age ≤ 14 years) LN patients registered in Department of Pediatric Nephrology of Tehran University of Medical Sciences. All patients underwent a renal biopsy with report based on the WHO classification.

Of the patients, 27% were below 10 years of age. Class IV nephritis was the most frequent histological finding comprising 42 (70%) of our population. Overall, five patients died and nine developed end-stage renal failure. Patient survival and kidney function survival for the whole population were 98% and 94%, 91% and 98%, 94% and 88% for years 1, 2, and 3 after initial diagnosis, respectively. Initial creatinine concentration was significantly associated with kidney failure ( p = 0.01) but not with patient survival. Anemia and hematuria were significantly associated with more rapid progression of systemic lupus erythematosus to nephritis. Patients who developed pericarditis had significantly poorer patient survival ( p < 0.05). Other laboratory and pathological findings (including activity and chronicity scores, disease classes) had no impact on patient or kidney function survival.

We found that LN in Iranian children has a comparable outcome with previous reports, especially regional. The poorer outcome observed in our patients compared with some other studies may be related to the younger age and the existence of more risk factors in our patients.