Clinical and morphological correlations in patients with lupus nephritis: a retrospective study

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Abstract

Aim. To analyze associations between clinical and morphological features of kidney involvement in patients with systemic lupus erythematosus.

Materials and methods. In the retrospective cohort study, we enrolled adult (≥18 years) patients with morphologically proven lupus nephritis (LN) stratified according to the ISN/RPS classification. Systemic lupus erythematosus was classified in accordance with ACR/EULAR classification criteria (2019). Antiphospholipid syndrome was diagnosed according to the 2006 classification criteria. Disease activity was assessed with SELENA-SLEDAI score.

Results. We enrolled 62 patients with LN, among them 84% were females. Median age of SLE onset was 23 (16,3; 30,8) years. In all cases kidney involvement was accompanied by extrarenal manifestations, among which joint (82%), skin (57%) and hematological involvement (68%) was the most common. LN class I was proven in one patient, class II – in three patients, class III – in 24, including III+V in seven, class IV – in 18, including IV+V in two, class V – in 13, class VI – in three patients. APS nephropathy was diagnosed in 4 (6.5%) of patients with LN. The most common clinical manifestation was proteinuria (85%), however its prevalence, level and the frequency of nephrotic syndrome showed no significant differences between the LN classes. LN III/IV±V was characterized by the highest levels of serum creatinine (and the lowest eGFR) at the time of biopsy.

Conclusion. LN is characterized by the high heterogeneity of the clinical and morphological manifestations, which makes LN class prediction impossible without kidney biopsy.

About the authors

Kseniia V. Kurginian

Sechenov First Moscow State Medical University (Sechenov University)

Email: nmbulanov@gmail.com
ORCID iD: 0009-0006-6038-7384

ординатор каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Ekaterina S. Stoliarevich

Moscow City Hospital No. 52; Russian University of Medicine

Email: nmbulanov@gmail.com
ORCID iD: 0000-0002-0402-8348

д-р мед. наук, проф. каф. нефрологии, нефролог и патологоанатом Московского городского нефрологического центра

Russian Federation, Moscow; Moscow

Mariia A. Litvinova

Sechenov First Moscow State Medical University (Sechenov University)

Email: nmbulanov@gmail.com
ORCID iD: 0000-0002-3136-2755

ассистент каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Valeria A. Kokhanchuk

Sechenov First Moscow State Medical University (Sechenov University)

Email: nmbulanov@gmail.com
ORCID iD: 0000-0003-1827-1100

студентка Клинического института детского здоровья им. Н.Ф. Филатова 

Russian Federation, Moscow

Savely N. Shevchenko

Sechenov First Moscow State Medical University (Sechenov University)

Email: nmbulanov@gmail.com
ORCID iD: 0009-0004-4758-9315

студент Клинического института детского здоровья им. Н.Ф. Филатова

Russian Federation, Moscow

Valeriia A. Pugach

Sechenov First Moscow State Medical University (Sechenov University)

Email: nmbulanov@gmail.com
ORCID iD: 0009-0004-0430-2177

ординатор каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

Pavel I. Novikov

Sechenov First Moscow State Medical University (Sechenov University)

Email: nmbulanov@gmail.com
ORCID iD: 0000-0003-0148-5655

канд. мед. наук, зав. ревматологическим отд-нием Клиники ревматологии, нефрологии и профпатологии им. Е.М. Тареева

Russian Federation, Moscow

Sergey V. Moiseev

Sechenov First Moscow State Medical University (Sechenov University); Lomonosov Moscow State University

Email: nmbulanov@gmail.com
ORCID iD: 0000-0002-7232-4640

чл.-кор. РАН, д-р мед. наук, проф., зав. каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н.В. Склифосовского, дир. Клиники ревматологии, нефрологии и профпатологии им. Е.М. Тареева Университетской клинической больницы №3, проф. каф. внутренних болезней фак-та фундаментальной медицины

Russian Federation, Moscow; Moscow

Nikolay M. Bulanov

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: nmbulanov@gmail.com
ORCID iD: 0000-0002-3989-2590

канд. мед. наук, доц. каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н.В. Склифосовского

Russian Federation, Moscow

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