Introduction:
Lupus nephritis (LN) affects 60% of patients with Systemic Lupus Erythematosus (SLE) leading to significant morbidity and mortality. The clinical presentation of LN is diverse, ranging from asymptomatic proteinuria to rapidly progressive renal failure. In most of the patients renal biopsy is performed which aids the clinical management. Response to therapy is an important determinant for renal and patient outcomes.
Methods:
This was a retrospective observational study of LN patients from 2011 to 2023. Data on clinical features, biochemical parameters, biopsy reports, and treatment details were obtained from the medical digital records of the patients visiting hospitals affiliated with Tertiary Care Centre, South India. Outcomes in terms of remissions, relapses, progression to dialysis dependency and patient survival were assessed
Results:
The study cohort consisted of 204 patients with SLE, of whom 90 (44.1%) had biopsy-proven lupus nephritis (LN). The mean age of these patients was 29 ± 14 years, with a male-to-female ratio of 1:9.8. The most common presentation was fever (69%) followed by pedal edema (68%), joint involvement (66%), oral ulcers (54%) and 45% patient had hypertension. Most of them had nephrotic-nephritic syndrome at the presentation. One fifth patients had hypothyroidism as an associated co-morbidity. Class IV LN was the most common histological presentation in 36 patients followed by class III (n=16) and class II (n=15). Renal histological transformation was observed in 8.1% of LN patients. Cyclophosphamide was the predominant induction agent (75%) used for the treatment of class IV with mycophenolate mofetil (MMF) as the maintenance drug. Following induction therapy, complete remission was achieved in two third (62%) of patients. No-response to therapy was seen in 10%. Progression to chronic kidney disease (CKD) was observed in five patients with dialysis dependence in three patients. 3 patients died during the follow-up period due to infection. Th overall patient survival was 96%.
Conclusions:
Lupus Nephritis is the common presentation with SLE in our cohort. Class IV LN was the most common histological diagnosis with two third patients achieving complete remission with therapy. LN, with timely diagnosis and appropriate treatment has good overall patient and renal survival.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.