Dr .Sheikh Muhammad Khan, Dr Allah Rakha, 3Dr Fazeelat Samad, Dr Muhammad Najam-ulHassan, Dr Mudasser Khalid

Clinical and Laboratory Predictors of Lupus Nephritis in Systemic Lupus Erythematosus

Abstract:

One of the most dangerous organ presentations of systemic lupus erythematosus (SLE), a multisystem autoimmune illness, is lupus nephritis (LN). Renal damage can be irreparable if renal involvement is not recognised right away. Thus, early detection and prompt intervention may be facilitated by the identification of clinical and laboratory predictors. To identify the laboratory and clinical indicators linked to the development of lupus nephritis in individuals with systemic lupus erythematosus. Over the course of a year, a prospective observational study was carried out at the Mayo Hospital Lahore’s Department of Rheumatology/Medicine. The presence of renal involvement was assessed in adult individuals with established SLE. Clinical symptoms, hypertension, disease activity, demographics, and the length of the illness were all noted. Complete blood count, serum creatinine, estimated glomerular filtration rate (eGFR), urinalysis, urine protein-to-creatinine ratio, 24-hour urine protein, complement C3 and C4 levels, anti-double-stranded DNA antibodies, and, if available, anti-C1q antibodies were among the laboratory tests. Clinical and laboratory data were used to define lupus nephritis, and when clinically necessary, renal biopsies were used to confirm the diagnosis. To find independent predictors of lupus nephritis, statistical analysis was done.A significant percentage of SLE patients had lupus nephritis. Patients with lupus nephritis had considerably higher rates of proteinuria, active urine sediment, elevated anti-dsDNA antibody levels, decreased C3 and C4 concentrations, hypertension, and impaired renal function. Significant proteinuria, high anti-dsDNA levels, low C3, low C4, and active urine sediment were found to be significant independent predictors of renal involvement on multivariable analysis.Clinical and laboratory criteria can offer useful information for determining which SLE patients are more likely to develop lupus nephritis. Among the most helpful predictors were proteinuria, active urine sediment, anti-dsDNA elevation, and hypocomplementemia. Early detection and treatment of lupus nephritis may be facilitated by routine renal surveillance that includes urine, renal function, and immunological evaluations.

Keywords: Complement C3; Complement C4; Proteinuria; Anti-dsDNA; Systemic lupus erythematosus; Lupus nephritis; Renal involvement; Predictors

Full text