An Analysis of the Correlation Between Clinical Indexes and Pathological Classifications in 202 Patients with Lupus Nephritis

J Inflamm Res. 2021 Dec 16:14:6917-6927. doi: 10.2147/JIR.S339744. eCollection 2021.

Abstract

Objective: To investigate the correlation between clinical indexes and pathological classifications in 202 patients with lupus nephritis (LN).

Methods: A total of 202 LN cases were retrospectively analyzed. All these patients met the four diagnostic criteria for systemic lupus erythematosus (SLE) of the American College of Rheumatology revised in 1997. The pathological diagnostic criteria of LN were in accordance with the pathological LN classification revised by the International Society of Nephrology and the Society of Kidney Pathology in 2003. The patients were scored according to the improved SLE Disease Activity Index 2000 (SLEDAI-2K), and their basic data, clinical data, laboratory data, and pathological data were collected.

Results: Among the 202 patients, the ratio of male to female was 1:5.73, and type IV was the most common pathological LN classification. There were differences in the urine analysis, hypertension incidence, blood cell analysis, blood lipids, renal function, plasma albumin, immunological indexes, renal pathological score among the different pathological types (P < 0.05). In the early finding of renal function damage of the patients, cystatin C sensitivity was significantly higher than that of serum creatinine and blood urea nitrogen. Multiple linear regression analysis show that there are strong correlations between AI and SLEDAI, 24hU-Pr, serum C3, serum ALB, BUN, creatinine, UA and PLT (P < 0.001); and there are correlations between AI and serum IgM, IgA, C4, TC and LDL-C (P < 0.05).

Conclusion: There is a clear correlation between pathological classifications and clinical indexes of LN.

Trial registration: Shen-PJ-2018-40, Study on Clinical and Molecular Mechanism of SLE.

Keywords: clinical indexes; kidney pathology; lupus nephritis.

Grants and funding

Key Projects of Yunnan Provincial Science and Technology Plan [No.: 2017FE468 (−004)] and the National Natural Science Foundation of China (No.: 81360457).