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Renal biopsy findings in new-onset systemic lupus erythematosus with clinical renal disease.
Int Urol Nephrol 2011; 43(3):801-6IU

Abstract

OBJECTIVES

Renal biopsy has been used extensively in systemic lupus erythematosus (SLE) with renal involvement. However, there is no complete agreement about the need for renal biopsy at presentation. The goal of this study is to define the role of renal biopsy as a therapeutic guide in new-onset SLE with renal involvement.

METHODS

We retrospectively analyzed renal biopsy findings in 131 SLE patients who received renal biopsy within 3 months from the diagnosis of SLE.

RESULTS

In patients presenting with acute renal failure, 91% of patients had proliferative lupus nephritis (LN) (class IV, mixed class V + III) and 9% had non-proliferative lupus nephropathy (pure class V). In patients presenting with nephrotic range proteinuria, proliferative LN (class III, IV, mixed class V + III) and non-proliferative lupus nephropathy (class II, pure class V) accounted for 55% and 36% of patients, respectively, whereas 9% had non-lupus nephropathy. With the exception of anti-double-stranded DNA, no clinical findings correlated with pathology. In patients presenting with sub-nephrotic proteinuria, 49% of patients had proliferative LN (class III, IV, mixed class V + III) and 51% had non-proliferative lupus nephropathy (class II, pure class V). Decreased C4 levels were more common in patients with proliferative LN (P = 0.031). In patients presenting with isolated hematuria, all were not active form nephropathy.

CONCLUSIONS

Our data suggested that similar clinical features may be observed despite very different classes of LN. Therefore, in new-onset SLE patients with clinical renal disease, early renal biopsy may be helpful in planning the treatment.

Authors+Show Affiliations

Division of Nephrology, Department of Internal Medicine, Changhua Christian Medical Center, 135, Nanhsiao Street, Changhua 500, Taiwan. wensnake1100@yahoo.com.tw

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21336956

Citation

Wen, Yao-Ko. "Renal Biopsy Findings in New-onset Systemic Lupus Erythematosus With Clinical Renal Disease." International Urology and Nephrology, vol. 43, no. 3, 2011, pp. 801-6.
Wen YK. Renal biopsy findings in new-onset systemic lupus erythematosus with clinical renal disease. Int Urol Nephrol. 2011;43(3):801-6.
Wen, Y. K. (2011). Renal biopsy findings in new-onset systemic lupus erythematosus with clinical renal disease. International Urology and Nephrology, 43(3), pp. 801-6. doi:10.1007/s11255-011-9911-3.
Wen YK. Renal Biopsy Findings in New-onset Systemic Lupus Erythematosus With Clinical Renal Disease. Int Urol Nephrol. 2011;43(3):801-6. PubMed PMID: 21336956.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Renal biopsy findings in new-onset systemic lupus erythematosus with clinical renal disease. A1 - Wen,Yao-Ko, Y1 - 2011/02/20/ PY - 2010/12/06/received PY - 2011/02/04/accepted PY - 2011/2/22/entrez PY - 2011/2/22/pubmed PY - 2012/1/21/medline SP - 801 EP - 6 JF - International urology and nephrology JO - Int Urol Nephrol VL - 43 IS - 3 N2 - OBJECTIVES: Renal biopsy has been used extensively in systemic lupus erythematosus (SLE) with renal involvement. However, there is no complete agreement about the need for renal biopsy at presentation. The goal of this study is to define the role of renal biopsy as a therapeutic guide in new-onset SLE with renal involvement. METHODS: We retrospectively analyzed renal biopsy findings in 131 SLE patients who received renal biopsy within 3 months from the diagnosis of SLE. RESULTS: In patients presenting with acute renal failure, 91% of patients had proliferative lupus nephritis (LN) (class IV, mixed class V + III) and 9% had non-proliferative lupus nephropathy (pure class V). In patients presenting with nephrotic range proteinuria, proliferative LN (class III, IV, mixed class V + III) and non-proliferative lupus nephropathy (class II, pure class V) accounted for 55% and 36% of patients, respectively, whereas 9% had non-lupus nephropathy. With the exception of anti-double-stranded DNA, no clinical findings correlated with pathology. In patients presenting with sub-nephrotic proteinuria, 49% of patients had proliferative LN (class III, IV, mixed class V + III) and 51% had non-proliferative lupus nephropathy (class II, pure class V). Decreased C4 levels were more common in patients with proliferative LN (P = 0.031). In patients presenting with isolated hematuria, all were not active form nephropathy. CONCLUSIONS: Our data suggested that similar clinical features may be observed despite very different classes of LN. Therefore, in new-onset SLE patients with clinical renal disease, early renal biopsy may be helpful in planning the treatment. SN - 1573-2584 UR - https://www.unboundmedicine.com/medline/citation/21336956/Renal_biopsy_findings_in_new_onset_systemic_lupus_erythematosus_with_clinical_renal_disease_ L2 - https://doi.org/10.1007/s11255-011-9911-3 DB - PRIME DP - Unbound Medicine ER -