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JOURNAL OF MEDICAL AND SURGICAL RESEARCH - Vol. III, n 2, December 2016

Pages: 286-295
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Renal Biopsy in Lupus Nephropathy: General Features and Preditors of Bad Prognosis.

Author: Mikou Souad, Tarik Sqalli, Mohammed Arryhani

Category: JMSR Nephrology

Abstract:

Introduction: Lupus nephritis is one of the most serious manifestations of systemic lupus erythematosus (SLE). It's responsible for a high morbid-mortality in young subjects. The aim of our study is to establish lupus nephritis epidemiology in our population, histological features and predictive factors of proliferative and active injuries and predictors of bad prognosis.

Results: Were enrolled 71 biopsies finding lupus nephritis among 700 kidney biopsies conducted in our nephrology department during the period of 6 years (10.14%).The average age of patients was 32.69 ± 11.48 years. A female predominance was observed (sex-ratio =0.2). The main indication for biopsy was the concomitant existence of proteinuria, hematuria and renal failure (48%). In univariate analysis, we retained as predictive factors of proliferative and active form: spring season flare with a maximum in June, pre-existing lupus nephritis, lymphopenia and nephrotic syndrome. Risks of progression to chronic renal failure were: female gender in 90% of cases (p <0.001), hypertension at admission (p <0.004), positive anti-Nuclear and anti-ds DNA Antibodies (p <0.04), renal failure at admission (p <0.0001). Morbidity associated with lupus nephritis is related to female gender (p <0.001), hypertension (p <0.001), renal failure at admission (p <0.001) and need for hemodialysis (p <0.001).

Conclusion: Lupus nephritis is severe in our series of 71 biopsies, with a high frequency of proliferative forms. Looking out the stigma of renal involvement during the disease progression and largest reflection of renal biopsy indications could improve the diagnosis and the management of LN.

Keywords: Classification, Lupus Nephritis, Renal Biopsy, Prognosis, Spring

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