LUPUS NEPHRITIS-A CRITICAL ANALYSIS OF 17 PATIENTS

Area of Science:

• Nephrology
• Rheumatology
• Internal Medicine

Background:

• Systemic lupus erythematosus (SLE) frequently involves the kidneys, leading to lupus nephritis.
• Renal lupus significantly impacts patient morbidity and mortality.
• Understanding the clinical and histological spectrum of renal lupus is vital for effective management.

Purpose of the Study:

• To analyze the clinical presentation, renal histology, and treatment outcomes of patients with renal lupus.
• To emphasize the importance of early diagnosis and aggressive management strategies.

Main Methods:

• Retrospective analysis of 17 patients diagnosed with renal lupus over a 3-year period.
• Evaluation of demographic data, clinical manifestations, serological markers (anti-dsDNA, ANA), renal function (serum creatinine), and renal histology (International Society of Nephrology/Renal Pathology Society classification).
• Treatment involved corticosteroids and cyclophosphamide pulses for advanced lupus nephritis (Class III/IV).

Main Results:

• 17 out of 28 SLE patients had renal lupus, predominantly affecting females (12/17) with a mean age of 32.2 years.
• Common renal manifestations included non-nephrotic proteinuria (64.70%), nephrotic syndrome (23.52%), and rapidly progressive glomerulonephritis (11.76%).
• Class IV lupus nephritis was most common (64.70%), with a mean serum creatinine of 2.4 mg/dl at presentation; 3 patients required dialysis.
• Aggressive treatment led to stabilization of serum creatinine in most patients, with one mortality due to pyopericardium.

Conclusions:

• Renal lupus presents with diverse renal manifestations and histological classes, frequently severe (Class III/IV).
• Early diagnosis and prompt, aggressive treatment with immunosuppressants are critical for improving renal outcomes and survival.
• This study underscores the treatable nature of renal lupus with timely intervention.