Morphometric analysis and its application in lupus nephritis: a systematic review.

Area of Science:

• Nephrology
• Pathology
• Digital Pathology

Background:

• Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus (SLE).
• Renal biopsy evaluation in LN suffers from histological heterogeneity and observer variability.
• Digital morphometry offers objective quantification of tissue lesions.

Purpose of the Study:

• To systematically review the application and utility of digital morphometry in lupus nephritis renal biopsies.
• To assess the diagnostic and prognostic value of digital morphometry in LN.

Main Methods:

• Systematic review following PRISMA guidelines.
• Inclusion of observational studies (adults, children, animal models) with biopsy-proven LN using digital morphometry.
• Searches across major scientific databases (PubMed, Embase, Scopus, etc.).

Main Results:

• 46 studies were included, analyzing glomerular, tubulointerstitial, and vascular compartments.
• Digital morphometry assessed parameters like cellularity, fibrosis, and immune deposits.
• Morphometry outperformed visual evaluation, especially in fibrosis quantification and prognosis prediction.

Conclusions:

• Digital morphometry is a valuable tool for comprehensive LN renal biopsy assessment.
• It enhances objectivity, reproducibility, and prognostic value in characterizing renal damage.
• Standardization and AI integration could further optimize LN diagnosis and treatment.