Evaluation Of Renal Involvement In Systemic Lupus Erythematosus Clinical Profile And Outcomes Of Lupus Nephritis

Original Article

Abstract

Background: Lupus nephritis (LN) is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Disease prognosis is closely related to histological class, and early diagnosis with timely treatment is essential to prevent irreversible renal damage and improve survival outcomes.

Objective: To evaluate the clinical presentation, laboratory findings, histological patterns, treatment response, and predictors of poor renal outcomes in patients with lupus nephritis.

Methods: This retrospective observational cohort study was conducted at the Department of Nephrology, Institute of Kidney Diseases, Peshawar, from January 2021 to December 2023. Adult patients (≥18 years) diagnosed with LN based on ISN/RPS classification were included. Data on demographics, clinical features, laboratory findings, and treatment were collected. Renal outcomes were categorized as remission, chronic kidney disease (CKD), or death. Statistical analysis was performed using SPSS version 24.0, with significance set at p < 0.05.

Results: A total of 100 patients were included, of whom 85.8% were female. The mean age was 27.4 years. Class IV LN was the most common (44.1%), followed by Class III (26.6%) and Class V (18.3%). Most patients presented with proteinuria (91.6%) and hypertension (53.3%). Remission was achieved in 62.5% of patients, while 25.8% progressed to CKD and 11.7% died. Elevated serum creatinine (>1.3 mg/dL) and advanced histological class (IV/V) were significantly associated with poor outcomes (p = 0.002). Early initiation of immunosuppressive therapy was linked to improved outcomes (p = 0.01).

Conclusion: Lupus nephritis remains a major determinant of renal outcomes in SLE. Early diagnosis, timely biopsy, appropriate immunosuppressive therapy, and regular follow-up are critical for improving long-term prognosis.