Clinicopathological Correlation of Lupus Nephritis

Korean Journal of Nephrology 2009;28(5):410-417.

Sun Jin You, M.D., Joon-Sung Park, M.D., Jee-Hyun Kim, M.D., Su-Kyoung Park, M.D., Sang Cheol Bae, M.D., Gheun-Ho Kim, M.D., Chong Myung Kang, M.D., Moon Hyang Park, M.D. and Chang-Hwa Lee, M.D.

Department of Internal Medicine¹
Department of Pathology²
Hanyang University College of Medicine

임상연구 : 루푸스 신염의 임상지표와 조직학적 분류의 연관성

유선진1, 박준성1, 김지현1, 박수경1, 배상철1, 김근호1, 강종명1, 박문향2, 이창화1

한양대학교 의과대학 내과학교실1, 병리학교실2

Abstract

Purpose:Clinical treatment for lupus nephritis largely depends upon histological renal biopsy classification. But it has been reported that serologic biochemical markers are not strongly associated with pathologic classification. The aim of this study is to see whether serologic markers could predict pathologic class of lupus nephritis for appropriate treatment. Methods:We investigated 67 patients, who underwent renal biopsy with lupus nephritis at Hanyang University Hospital between January, 2005 and August, 2007. Biological markers for this study are hematuria, proteinuria, serologic data of lupus activity and azotemia. They were retrospectively analyzed from patients grouped by ISN/RPS 2003 lupus nephritis classification. Results:Total 67 patients (men 5, women 62) were enrolled and the mean age of the patients was 30.6±9 years. The number of patient group by pathologic classification was 4 cases for class II, 15 cases for class III, 30 cases for class IV and 15 cases for class V. Spot urine protein to creatinine ratio more than 3 increased in class IV group statistically (p=.007). C3 level decreased more in class IV group than class III, V groups. Ten patients showed azotemia, and 9 of them were class IV group (p=.048). Conclusion:The patients with more increased proteinuria, decreased C3 level and azotemia showed more frequently in class IV group. Hence those three biological markers may be a clinical clue to pathologic diagnosis.

Key Words: Lupus nephritis, Biochemical marker, Pathology