Factors Associated with Renal Outcomes in an Inception Cohort of Biopsy-proven Lupus Nephritis Patients

Objective: To identify the clinical factors associated with renal response and flare in lupus nephritis (LN). Methods: All 115 patients with biopsy-proven LN diagnosed between January 2002 and June 2015 in a tertiary centre comprised of an inception cohort that was followed up until February 2017. Baseline demographic, clinical parameters, renal biopsy histology, induction and maintenance immunosuppressive therapies, complete renal response (CRR), creatinine doubling, end-stage renal disease (ESRD), renal flares and infections were retrieved and analyzed with univariate log-rank test and multivariate Cox regression. Results: At the time of the first renal biopsy, the age of patients was 38 ± 12.2 years (mean ± standard deviation), 90% female and systemic lupus erythematosus (SLE) disease duration 46 months (median); 67.0% were LN class IV or class IV + V. Patients were followed up for 104 ±49 months after biopsy. At months 3, 6, 12 and 24, a cumulative 25%, 46%, 66% and 76% of patients had achieved CRR, respectively. However, 49.5% who had CRR experienced [Formula: see text]1 infection of renal flare, with cumulative risk of 5%, 17%, 25% and 43% at year 1, 2, 3 and 5, respectively. Multivariate analysis showed that nephrotic syndrome ([Formula: see text] = 0.03) and delay of renal biopsy [Formula: see text]2 months from the onset of LN ([Formula: see text] ¡ 0.01) were negatively associated with CRR. Hydroxychloroquine use was beneficial in attaining CRR ([Formula: see text] = 0.03, hazard ratio = 1.70, 95% CI: 1.04, 2.80) and preventing renal flare ([Formula: see text] = 0.01, odds ratio = 0.51, 95% CI: 0.29, 0.88). By the end of the study, 80% of patients remained in CRR though 10.4% patients ended up in ESRD (all class IV), 8.7% died and 28.7% had [Formula: see text]1 infection episode requiring hospitalization. Conclusion: Most LN patients could achieve CRR after immunosuppressive therapy but renal flares were common over time. Infective complications were fairly frequent but the incidence of ESRD was low. The use of hydroxychloroquine was associated with better renal response and fewer flares.

Download Full-text

Complete renal response at 12 months after induction therapy is associated with renal relapse-free rate in lupus nephritis: a single-center, retrospective cohort study

Lupus ◽

10.1177/0961203319829827 ◽

2019 ◽

Vol 28 (4) ◽

pp. 501-509 ◽

Cited By ~ 8

Author(s):

K Ichinose ◽

M Kitamura ◽

S Sato ◽

M Eguchi ◽

M Okamoto ◽

...

Keyword(s):

Lupus Nephritis ◽

Renal Biopsy ◽

Induction Therapy ◽

Predictive Factors ◽

Lupus Erythematosus ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Renal Response

Background Lupus nephritis (LN) is a major risk factor for overall morbidity and mortality in systemic lupus erythematosus (SLE). Methods We retrospectively analyzed cases of proliferative and membranous LN patients who underwent a renal biopsy at our hospital in 1993–2016. We analyzed the association between complete renal response (CR) rates at 12 months after induction therapy and predictive factors for CR and their association with renal flares. Results Of the 95 cases analyzed, we were able to track the therapeutic responses of 81 patients at 12 months after their induction therapy. The median follow-up duration after renal biopsy was 51 months (interquartile range: 16.5–154.5 months). The Cox proportional hazards model showed that, compared to not attaining CR at 12 months, the attainment of CR at 12 months was correlated with being free from renal flares. The multivariate logistic analysis revealed that the predictive factors for CR at 12 months were the anti-La/SSB antibodies (U/ml) (odds ratio (OR) 1.22, 95% confidence interval (CI) 1.01–1.63, p = 0.0220), blood urea nitrogen (BUN) (OR 0.68, 95% CI 0.44–0.90, p = 0.00048) and serum β2 microglobulin (MG) (OR 0.26, 95% CI 0.06–0.74, p = 0.00098) levels. Conclusions Among LN patients, being free from renal flares was associated with attaining CR at 12 months after induction therapy. Anti-La/SSB antibodies were a positive predictive factor, and BUN and serum β2MG levels were negative predictive factors of CR at 12 months.

Download Full-text

Renal outcome after kidney-transplantation in Korean patients with lupus nephritis

Lupus ◽

10.1177/0961203317725591 ◽

2017 ◽

Vol 27 (3) ◽

pp. 461-467 ◽

Cited By ~ 6

Author(s):

E S Park ◽

S S Ahn ◽

S M Jung ◽

J J Song ◽

Y-B Park ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Kidney Transplantation ◽

Lupus Nephritis ◽

Lupus Erythematosus ◽

Graft Failure ◽

Renal Outcome ◽

Class Iii ◽

Systemic Lupus ◽

Renal Flare ◽

Class Iv

We investigated renal outcome of kidney-transplantation in 19 Korean recipients with biopsy-proven lupus nephritis and compared it with 18 Korean age- and gender-matched recipients without lupus nephritis who were diagnosed with end-stage renal disease caused by renal diseases other than lupus nephritis in a single centre. We reviewed histological findings of kidneys and calculated cumulative dose of immunosuppressive agents. We assessed renal flare of systemic lupus erythematosus, recurrence of lupus nephritis and graft failure as prognosis. The mean age of recipients with lupus nephritis was 43.5 years and all patients were female. Six patients had class III, 10 had class IV and three had class V. There were no meaningful differences in demographic data, renal replacement modality, cumulative doses of immunosuppressants and prognosis between recipients with and without lupus nephritis. Eight patients experienced renal flare of systemic lupus erythematosus, but there were no cases of recurrence of lupus nephritis or graft failure in recipients with lupus nephritis. Kidney-recipients with class IV lupus nephritis exhibited a lower cumulative renal flare of systemic lupus erythematosus free survival rate than those with class III lupus nephritis. In conclusion, renal outcome of kidney-transplantation in patients with lupus nephritis is similar to that in those without lupus nephritis, and class IV was associated with renal flare of systemic lupus erythematosus.

Download Full-text

Changing patterns in clinical–histological presentation and renal outcome over the last five decades in a cohort of 499 patients with lupus nephritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2017-212732 ◽

2018 ◽

Vol 77 (9) ◽

pp. 1318-1325 ◽

Cited By ~ 38

Author(s):

Gabriella Moroni ◽

Paolo Gilles Vercelloni ◽

Silvana Quaglini ◽

Mariele Gatto ◽

Davide Gianfreda ◽

...

Keyword(s):

Lupus Nephritis ◽

Lupus Erythematosus ◽

Proportional Hazards ◽

Cox Regression ◽

Activity Index ◽

Progressive Increase ◽

Renal Outcome ◽

Rank Test ◽

Renal Survival ◽

Chronicity Index

ObjectivesTo evaluate changes in demographic, clinical and histological presentation, and prognosis of lupus nephritis (LN) over time.Patients and methodsWe studied a multicentre cohort of 499 patients diagnosed with LN from 1970 to 2016. The 46-year follow-up was subdivided into three periods (P): P1 1970–1985, P2 1986–2001 and P3 2002–2016, and patients accordingly grouped based on the year of LN diagnosis. Predictors of patient and renal survival were investigated by univariate and multivariate proportional hazards Cox regression analyses. Survival curves were compared using the log-rank test.ResultsA progressive increase in patient age at the time of LN diagnosis (p<0.0001) and a longer time between systemic lupus erythematosus onset and LN occurrence (p<0.0001) was observed from 1970 to 2016. During the same period, the frequency of renal insufficiency at the time of LN presentation progressively decreased (p<0.0001) and that of isolated urinary abnormalities increased (p<0.0001). No changes in histological class and activity index were observed, while chronicity index significantly decreased from 1970 to 2016 (p=0.023). Survival without end-stage renal disease (ESRD) was 87% in P1, 94% in P2% and 99% in P3 at 10 years, 80% in P1 and 90% in P2 at 20 years (p=0.0019). At multivariate analysis, male gender, arterial hypertension, absence of maintenance immunosuppressive therapy, increased serum creatinine, and high activity and chronicity index were independent predictors of ESRD.ConclusionsClinical presentation of LN has become less severe in the last years, leading to a better long-term renal survival.

Download Full-text

Histopathological findings of renal biopsy in systemic lupus erythematosus

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v3i2.20268 ◽

2016 ◽

Vol 3 (2) ◽

pp. 10-14

Author(s):

Sanjit Karki ◽

Roshan Shrestha ◽

Buddhi Paudyal ◽

Bimal Pandey ◽

Nora Ranjitkar ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Nephritis ◽

Renal Biopsy ◽

Lupus Erythematosus ◽

Renal Involvement ◽

Definitive Treatment ◽

Class Iii ◽

Systemic Lupus ◽

Morphological Pattern ◽

Class Iv

Introductions: Classifying morphological pattern of renal involvement is important in systemic lupus erythematosus (SLE) for definitive treatment and prognosis. This study aims to analyse the histopathological pattern of glomerula in SLE patients.Methods: This was a retrospective chart review of patients diagnosed with SLE who had renal biopsy during October 2013 to September 2015 at Patan Hospital.Results: There were 38 patients of SLE. Antinuclear antibody (ANA) was positive in all 38 (100 %), Anti-dsDNA seen in 18 (47.4%). Active urinary sediment & proteinuria was seen in 25 (65.8%) patients and proteinuria in 13 (34.2%) patients. Histopathological patterns were of glomerular involvement, ISN Class II in 2 (5.3%), Class III in 2 (5.3%), class IV in 20 (52.5%), Class V in 6 (15.8%) and mixed IV-V in 8 (21.1%).Conclusions: The diffuse proliferative lupus nephritis (ISN Class IV) was the most common pattern of lupus nephritis encountered in our study followed by mixed pattern (ISN Class IV & V) and membranous lupus nephritis (ISN class IV). Journal of Patan Academy of Health Sciences. 2016 Dec;3(2):10-14

Download Full-text

Comparison of complete renal response and mortality in early- and late-onset lupus nephritis: A multicenter retrospective study of a Japanese cohort

10.21203/rs.3.rs-29286/v2 ◽

2020 ◽

Author(s):

Kunihiro Ichinose ◽

Mineaki Kitamura ◽

Shuntaro Sato ◽

Keita Fujikawa ◽

Yoshiro Horai ◽

...

Keyword(s):

Lupus Nephritis ◽

Renal Biopsy ◽

Lupus Erythematosus ◽

Early Onset ◽

Proportional Hazards Model ◽

Late Onset ◽

Cox Proportional Hazards Model ◽

University Hospital ◽

Renal Response ◽

Female Sex

Abstract Background: Most patients with systemic lupus erythematosus (SLE) progress to lupus nephritis (LN) within 5 years of their SLE diagnosis, although it is not uncommon for LN to develop at later time points. Here we evaluated the clinical features of early- and late-onset LN.Patients and Methods: We retrospectively analyzed the cases of 184 of the 201 patients who underwent a renal biopsy at Nagasaki University Hospital and associated community hospitals between 1990 and 2016 and were diagnosed as having LN. Early-onset was defined as the development of LN within the first 5 years after the patient's SLE diagnosis, and late-onset was defined as LN development >5 years post-diagnosis. We analyzed the complete renal response (CR) at 6 and 12 months after induction therapy, the classification of renal pathology, and the mortality of the early- and late-onset LN groups.Results: The mean follow-up duration after renal biopsy was 123±85 months. There were 113 (61.4%) early-onset patients and 71 (38.6%) late-onset patients. A multivariate analysis revealed that the following factors were predictive of CR. At 6 months: female sex (odds ratio [OR] 4.64, 95% confidence interval [CI] 1.66–12.98, p=0.002), proteinuria (OR 0.82, 95%CI 0.70–0.95, p=0.003), index of activity (0–24) (OR 0.85, 95%CI 0.74–0.97, p=0.014), and early-onset LN (OR 2.26, 95%CI 1.11–4.58, p=0.023). At 12 months: female sex (OR 3.95, 95% CI 1.62–9.64, p=0.002), index of activity (0–24) (OR 0.80, 95%CI 0.71–0.91, p<0.001), and early-onset LN (OR 1.98, 95%CI 1.04–3.79, p=0.038). In a Cox proportional hazards model, the early-onset LN group had a significantly better mortality rate than the late-onset LN group (p=0.038).Conclusions: In our cohort, early-onset LN was a better predictor of CR at 6 and 12 months. Our results suggest that early-onset LN patients had lower mortality than late-onset LN patients.

Download Full-text

Comparison of complete renal response and mortality in early- and late-onset lupus nephritis: A multicenter retrospective study of a Japanese cohort

10.21203/rs.3.rs-29286/v1 ◽

2020 ◽

Author(s):

Kunihiro Ichinose ◽

Mineaki Kitamura ◽

Shuntaro Sato ◽

Keita Fujikawa ◽

Yoshiro Horai ◽

...

Keyword(s):

Lupus Nephritis ◽

Renal Biopsy ◽

Lupus Erythematosus ◽

Early Onset ◽

Proportional Hazards Model ◽

Late Onset ◽

Female Gender ◽

Cox Proportional Hazards Model ◽

University Hospital ◽

Renal Response

Abstract Background Most patients with systemic lupus erythematosus (SLE) progress to lupus nephritis (LN) within 5 years of their SLE diagnosis, although it is not uncommon for LN to develop at later times. Here we evaluated the clinical features of early- and late-onset LN. Patients and Methods: We retrospectively analyzed the cases of a total of 184 of the 201 patients who underwent a renal biopsy at Nagasaki University Hospital and community hospitals between 1990 and 2016 and were diagnosed as having LN. Early-onset was defined as the development of LN within the first 5 years after the patient's SLE diagnosis, and late-onset was defined as LN development > 5 years post-diagnosis. We analyzed the complete renal response (CR) at 6 and 12 months after induction therapy, the classification of renal pathology, and the mortality of the early- and late-onset LN groups. Results The mean follow-up duration after renal biopsy was 123 ± 85 months. There were 113 (61.4%) early-onset patients and 71 (38.6%) late-onset patients. A multivariate analysis revealed that the following factors were predictive of CR. At 6 months: female gender (odds ratio [OR] 4.64, 95% confidence interval [CI] 1.66–12.98, p = 0.002), proteinuria (OR 0.82, 95%CI 0.70–0.95, p = 0.003), index of activity (0–24) (OR 0.85, 95%CI 0.74–0.97, p = 0.014), and early-onset LN (OR 2.26, 95%CI 1.11–4.58, p = 0.023). At 12 months: female gender (OR 3.95, 95% CI 1.62–9.64, p = 0.002), index of activity (0–24) (OR 0.80, 95%CI 0.71–0.91, p < 0.001), and early-onset LN (OR 1.98, 95%CI 1.04–3.79, p = 0.038). In a Cox proportional hazards model, the early-onset LN group had a significantly better mortality rate than the late-onset LN group (p = 0.038). Conclusions In our cohort, early-onset LN was a better predictor of 6- and 12-month of CR attainment. Our results suggest that early-onset LN patients had better mortality than late-onset LN patients.

Download Full-text

The current role for clinical and renal histological findings as predictor for outcome in Australian patients with lupus nephritis

Lupus ◽

10.1177/0961203318792361 ◽

2018 ◽

Vol 27 (11) ◽

pp. 1838-1846 ◽

Cited By ~ 4

Author(s):

J Nossent ◽

W Raymond ◽

A Kang ◽

D Wong ◽

M Ognjenovic ◽

...

Keyword(s):

Lupus Nephritis ◽

Renal Biopsy ◽

Lupus Erythematosus ◽

Renal Damage ◽

Cox Regression ◽

Antihypertensive Drugs ◽

Renal Outcome ◽

Histological Findings ◽

Renal Survival ◽

Dsdna Antibody

Objectives To investigate the current demographic, clinical and histological characteristics of patients with lupus nephritis (LN) in Western Australia (WA) with regards to their predictive value for patient and renal outcome. Methods Retrospective study of adult systemic lupus erythematosus (SLE) patients with a first renal biopsy demonstrating LN between 1997 and 2017 at a metropolitan tertiary hospital in WA. Clinical data were collected at baseline and last follow-up with renal biopsy findings classified by International Society of Nephrology (ISN) criteria. Annual incidence rates (AIRs)/100,000, Kaplan–Meyer curves and Cox regression hazard ratio for independent predictors for patient and renal survival were applied. Results The AIR was 3.3, 3.1 and 0.4 for Asian ( n = 29), Indigenous Australian (IA) ( n = 11) and Caucasian ( n = 43) patients, respectively ( p < 0.01). There was no significant subgroup difference regarding ISN class (proliferative 66%, membranous 19%, mesangial 15%), levels of proteinuria (median PCR 300 mg/mmol) or frequency of raised creatinine (31%), anti-dsDNA antibody (89%) or hypocomplementaemia (88%). Treatment included corticosteroids (91%), cyclophosphamide (30%), mycophenolate (67%) and antihypertensive drugs (67%). Five- (81%) and 10-year (70%) survival was lower for IAs than for Caucasians and Asians (95% each at both time points) ( p = 0.016). Five- and 10-year renal survival (endpoint renal replacement therapy (RRT)) was 86% and 64% for IA vs 100% for Asian, 100% and 96% for Caucasian patients ( p = 0.02). IA background was the only independent predictor for poor patient survival and together with male gender also for renal survival. Only 25% of all patients remained free of any organ damage with non-renal damage observed in 53% of survivors. Conclusions LN incidence in WA was 0.75/100,000 with the lowest rate observed in Caucasians. While Asian patients have the same favourable outlook as Caucasians, the outcome is much bleaker for IA patients. Other clinical and histological findings did not predict outcomes, and importantly more than half of all surviving patients accrued non-renal damage.

Download Full-text

Lupus nephritis with an unusual histopathological pattern

Portuguese Journal of Nephrology & Hypertension ◽

10.32932/pjnh.2021.04.119 ◽

2021 ◽

Vol 35 (1) ◽

pp. 51-54

Author(s):

Marcelo Aveiro ◽

◽

Nicole Pestana ◽

Francisca Silva ◽

Pedro Vieira ◽

...

Keyword(s):

Lupus Nephritis ◽

Renal Biopsy ◽

Lupus Erythematosus ◽

Urine Analysis ◽

Blood Analysis ◽

Proteinase 3 ◽

Diagnostic Measures ◽

Multiple Organs ◽

Poor Treatment ◽

Class Iv

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple organs. When the kidney is involved it is generally termed lupus nephritis (LN), and is a major contributor to the morbidity and mortality associated with SLE. The classic pattern of lupus nephritis in a renal biopsy is an immune complex mediated glomerulonephritis. The presence of crescents, in diffuse proliferative lupus nephritis, and serologic positivity for antineutrophil cytoplasmatic antibodies (ANCA), more often antimyeloperoxidase than anti-proteinase 3, has been linked with specific clinicopathological features, poor treatment response and a worse kidney survival. Clinical case: We present the case of a 19-year-old male, without relevant past medical history, who presented severe headaches, hypertension and peripheral edema. The blood analysis revealed hemoglobin (Hb) 7.6 g/dL, creatinine (Cr) 2.64 mg/dL, blood urea nitrogen (BUN) 101 mg/dL, and urine analysis, hematuria and nephrotic proteinuria. The autoimmunity panel results were consistent with SLE paired with positivity for ANCA-proteinase 3 antibody. A renal biopsy revealed crescentic glomerulonephritis with fibrinoid necrosis and Bowman capsule rupture. The patient was diagnosed with class IV LN. The initiation treatment consisted of cyclophosphamide (CIPH) and prednisolone (PDN). At the 6-month follow-up, CIPH was stopped and mycophenolate mofetil (MMF) initiated as maintenance therapy, combined with PDN. Although microscopic hematuria and C3 consumption were still present (a new biopsy was pondered but the patient refused any further invasive diagnostic measures), C1q levels decreased from 26.6 to 19.3 U/ml (negative if < 20 U/ml) and anti-dsDNA was also negative with progressive declination of the degree of proteinuria. The creatinine levels returned to normal. Conclusion: The authors emphasize the importance of this class IV LN, influenced by the association with anti-proteinase 3, due to the implications in the histopathological pattern and in therapy selection. In this specific case kidney function, proteinuria and lupus activity had an important decrease without significant complications with the chosen treatment.

Download Full-text

Particularities of the Evolution and Therapeutic Response in Men with Systemic Lupus Erythematosus and Lupus Nephritis

Internal Medicine ◽

10.2478/inmed-2019-0089 ◽

2019 ◽

Vol 16 (6) ◽

pp. 7-17

Author(s):

Anna Mirela Stroie ◽

Mircea Niculae Penescu ◽

Nicoleta Petre ◽

Geanina Beldea

Keyword(s):

Systemic Lupus Erythematosus ◽

Side Effects ◽

Lupus Nephritis ◽

Renal Biopsy ◽

Lupus Erythematosus ◽

Therapeutic Response ◽

Immunosuppressive Agents ◽

Systemic Lupus ◽

Male Patients ◽

Class Iv

AbstractAim. The prevalence ratio of systemic lupus erythematosus in men compared to women is 1:10, with more aggressive forms in men and in children. The incidence of lupus nephritis is of 50-60% in patients with lupus.In this paper, we aim to report on a series of cases that include male patients who had lupus nephritis via renal biopsy and were admitted between January 2011 - December 2017, with or without other SLE manifestations. The aim is to review the particularities and the therapeutic response: age at onset, disease duration, lupus nephritis class, extra-renal organ involvement of lupus disease, paraclinical findings – proteinuria, inflammatory syndrome, renal function, therapeutic response – immunosuppressive regimens used for induction and maintenance, remission onset, remission type, number of flares, side effects of immunosuppressive therapy.Materials and method. We have reviewed the histopathology database of male patients with lupus nephritis revealed via renal biopsy, medical charts and the Hippocrates information system in order to collect patient data.Outcomes. Out of 68 renal biopsies positive for lupus nephritis, 9 were from male patients, which reveals a 6.5:1 ratio. The average age at the time of the renal biopsy is 37. 33 years old. Lupus nephritis class - 8 out of 9 patients were class IV, 1 sample was class IV+V. The duration of the corticosteroid therapy is 6.6 years. In addition, we also reviewed the immunosuppressive agents used, the number of flares, and the side effects of the medication.Conclusions. Our data are similar to the literature data.

Download Full-text

CLINICO-PATHOLOGICAL CHARACTERISTICS OF LUPUS NEPHRITIS IN EASTERN ZONE OF INDIA: A SINGLE TERTIARY CENTER EXPERIENCE

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2016.v9i5.12558 ◽

2016 ◽

Vol 9 (5) ◽

pp. 102 ◽

Cited By ~ 1

Author(s):

Smaraka Ranjan Panda ◽

Chittaranjan Kar ◽

Prasant Kumar Sahu ◽

Sashibhusan Rout ◽

Bishwaranjan Mohanty ◽

...

Keyword(s):

Lupus Nephritis ◽

Renal Biopsy ◽

Lupus Erythematosus ◽

Prognostic Information ◽

Urine Sediment ◽

Laboratory Findings ◽

Medical College ◽

Tertiary Center ◽

Renal Biopsies ◽

Class Iv

ABSTRACTObjective: Lupus nephritis (LN) is the most common and serious manifestation of systemic lupus erythematosus (SLE) and an important cause ofmorbidity and mortality. Although diagnosis of LN is straight forward in a patient with SLE and proteinuria, and active urine sediment and perhapsrenal insufficiency, still renal biopsies are required at diagnosis to enable classification of nephritis severity, to provide prognostic information, and toguide treatment. Hence, the objective of this study is to determine the frequency of distribution of different classes of LN based on renal biopsy reportsand to correlate it with various laboratory findings.Methods: Retrospective study was done in all patients with LN who had at least one representative renal biopsy and evaluated in NephrologyDepartment of SCB Medical College, Cuttack, in 6-month duration. Various laboratory values were recorded and correlated with histopathologicallupus classifications.Results: Out of 35 patients enrolled, 33 (94.28%) were females and 2 (5.71%) were males. Mean age was 27.53±12.26 years. Majority of cases belongto Class IV followed by Class V. Patients of Class IV LN have a significantly low hemoglobin level. Similarly, serum urea and creatinine are higher inGroup IV than other groups, and serum creatinine was found to be significant. 24 hrs urinary protein excretion has a significant correlation with theclasses of LN.Conclusion: This study suggests some meaningful correlation between laboratory findings and histopathological lupus classification. This study alsosuggests that renal biopsies are still beneficial for better evaluation of renal status and determination of LN classes.Keywords: Clinico-pathological correlation, Lupus nephritis, Biopsy.

Download Full-text