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Patients with Lupus Nephritis (LN) may present with a decreased estimated Glomerular Filtration Rate (eGFR), which is not always related to the outcome.
Aim
To correlate the Activity and Chronicity Indices with Creatinine and Albumin in patients who debuted with LN with histopathological classes III, IV, III + V and IV + V and had eGFR < 60 mL/min at diagnosis.
Methods
Retrospective and analytical study. Hospitalized patients with a diagnosis of Systemic Lupus Erythematosus were included who underwent a renal biopsy between May 2019 and April 2023 with an eGFR <60 mL/min on admission, with a histopathological diagnosis of Lupus Nephritis in its pure proliferative classes and in combination of each one with the membranous (classes III, IV, III + V and IV + V). Serum Albumin and Creatinine at admission, 3 and 6 months were correlated with the Chronicity Index (CI) and with the Activity Index (AI). Analysis of non-parametric variables of Spearman correlation and comparison of means with ANOVA test was performed.
27 patients were included, 24 were women (88.8%), with a mean age of 28 years. The histopathological class IV + V predominated when identified in 20 (74%) of the patients, followed by class IV with 4 patients (14.8%), in third place, class III with 2 patients (7.4%) and finally a patient (3.7%) with class III + V.
Significant correlations were identified between Creatinine at 6 months and Creatinine at 3 months (r=0.83, p<0.0001), baseline Albumin with AI (r=-0.39, p=0.004); CI was correlated with baseline Albumin (r= 0.57, p<0.031) and Creatinine at 3 months (r=0.57, p=0.002).
In the patient hospitalized for Lupus Nephritis with a GFR < 60 mL/min, Albumin could be a serum marker upon hospital admission with a positive correlation with the histopathological criterion of Chronicity Index in the pure extracapillary variants or in combination with the membranous, regardless of the response or not to induction treatment.