A Study on Clinical Profile of Lupus Nephritis in Tertiary Care Centre

INTRODUCTION: Systemic lupus erythematosus is a chronic inflammatory disease with multisystem involvement having different clinical and immunological manifestation characterized by the presence of antinuclear antibodies. Renal involvement in SLE occurs in 40-75% patients most frequently in a period of 5 years after the onset of the disease. It is one of the strongest predictors of a poor outcome. six clinical manifestations are encountered in patients with lupus nephritis. Since nephritis is asymptomatic in most lupus patients, urinalysis should be ordered in any person of suspected SLE. The therapy of LN varies according to the histological classes. Early detection of renal involvement is essential to predict irreversible renal damage and renal failure. AIM AND OBJECTIVES: 1. To study the history- pathological abnormalities in patients diagnosed to have lupus nephritis 2.To correlate the clinical and laboratory findings with histo-pathological class of lupus nephritis. MATERIALS AND METHODS The present prospective study was done in Patients of SLE satisfying ACR criteria admitted to nephrology and medicine ward of TVMCH. The study was conducted with 50 patients, satisfying four ACR criteria, or atleast one clinical or one immunological criterion, and in Biopsy proven Lupus nephritis with ANA or anti double stranded DNA. Patients Age less than 18 years, known kidney disease, Diabetes, Hypertension, other connective tissue disorders, Patients with Reactive Hepatitis B, Hepatitis C, HIV are excluded from this study. RESULTS: In 50 cases, female population was 86%, there was a preponderance of female patients in our study. Mean age of presentation was 26 years. Most common clinical feature was edema. Hypertension was found in 26 patients. Proteinuria was found in all patients. Haematuria was present in 24% of study population. Blood urea and creatinine was higher in class 5 & 6. Most common class in renal biopsy was class IV. eGFR was reduced in all patients. CONCLUSION: In our study lupus nephritis is more common among females compared to males. Most common age of presentation in our study is between 31 to 40 years of age. Most of the patients were asymptomatic, lupus nephritis was identified during routine evaluation. Renal biopsy provides information on the class of lupus nephritis, tubular, vascular changes, activity and chronicity indices. In our study majority of the patients had class IV LN followed by class III