A clinical study of lupus nephritis in a tertiary care hospital in northeast India

Background Renal involvement is very common in SLE , with proliferative form being commonest type of lupus nephritis (LN), which is amenable to aggressive treatment. Objectives To determine the prevalence and clinical profile of LN in northeast India. Methods Fifty-two patients with LN, ≥12 years, were selected. Patients with overlap syndromes, end-stage renal disease, and other contraindications for renal biopsy were excluded. All selected patients underwent renal biopsy. Results LN was more common in younger females (mean age 24.5 years; female:male ratio 12:1). Histologically, International Society of Nephrology and Renal Pathology Society (ISN/RPS) Class-III was the commonest type of LN (32.69%), followed by class-IV (30.76%), with proliferative LN (Class III + IV) found in 63.45%. Renal manifestations included hypertension – 63.5%, renal insufficiency – 57.6%, nephrotic syndrome – 51.9%, and nephritic syndrome – 48.1%. Renal manifestations increased proportionately with the histological type of LN. Proliferative LN was significantly higher in younger females ( p < 0.001). Conclusion Proliferative LN was most common type of LN, which was significantly higher in younger females. Higher the histological class, more severe were the renal manifestations. Considering the higher incidence of proliferative LN in younger females necessitating aggressive treatment, there is need for early histological diagnosis of LN, especially in younger females, to initiate aggressive treatment, where indicated, for better long-term outcome.