Research Article
Clinicopathological Correlation in Asian Patients with
Biopsy-Proven Lupus Nephritis
Bancha Satirapoj, Pamila Tasanavipas, and Ouppatham Supasyndh
Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok 10400, hailand
Correspondence should be addressed to Bancha Satirapoj; satirapoj@yahoo.com
Received 8 January 2015; Revised 5 March 2015; Accepted 5 March 2015
Academic Editor: Richard Fatica
Copyright © 2015 Bancha Satirapoj et al. his is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
A total of 244 patients with lupus nephritis (219 women (89.8%) with a female to male ratio of 9:1) were included in the study.
Clinical and laboratory indings at renal biopsy are clinically valuable in identifying diferent renal classiications of lupus pathology,
activity, and chronicity index. Patients with class IVG had signiicantly higher proportions of microscopic hematuria, proteinuria,
hypertension, impaired renal function, anemia, hypoalbuminuria, and positive anti-DNA antibody. All of these indings correlated
well with high activity index and chronicity index of lupus pathology. Considering these correlations may help to determine the
clinicopathologic status of lupus patients.
1. Introduction
Renal involvement is one of the most severe complications
of systemic lupus erythematosus (SLE) and the clinical pre-
sentation of lupus nephritis (LN) is highly variable, ranging
from mild asymptomatic proteinuria to rapidly progressive
glomerulonephritis [1, 2]. he renal morphological expres-
sion can vary considerably among patients or within an
individual over time [3, 4]. Performing renal biopsies to
accurately determine the prognosis and to guide treatment
in LN patients is greatly needed. Recently, the International
Society of Nephrology/Renal Pathology Society (ISN/RPS)
2003 classiication of LN was proposed [5].
It has been generally agreed upon that renal morpho-
logical lesions and some clinical and laboratory features
are correlated. Several studies are available on the clinico-
pathological correlation in LN subjects mainly from devel-
oped countries [6, 7]. However, very few publications are
currently available concerning the demographic, clinical,
and pathological features of LN and their correlations in
hailand [8]. herefore, this study aimed to assess the clinical
and basic laboratory features of hai patients with biopsy-
proven LN class according to ISN/RPS 2003 classiication,
renal pathological activity, and chronicity index in patients
with LN. Clinical records were reviewed and information
regarding renal function, serological activity, and urinary
protein is collected and compared across histological classes.
2. Methods
2.1. Subjects. Patients with LN who underwent renal biopsy
between 2010 and 2013 in Phramongkutklao and Siriraj
Hospitals, Bangkok, hailand, were included in this study. All
patients met the American College of Rheumatology (ACR)
revised criteria for the classiication of SLE [9]. For inclusion,
patients had to have adequate renal biopsy samples for histo-
logical diagnosis, including >10 glomeruli. For the patients
who had repeated biopsies, samples and clinical records at
the time of the irst biopsy were used. Consequently, data of
244 patients were available in the study. For included patients,
clinical records and laboratory parameters at the time of
biopsy were collected. he research followed the tenets of the
Declaration of Helsinki; informed consent was obtained, and
the research was approved by the institutional review board.
2.2. Renal Pathological Diagnosis. Renal biopsy-conirmed
LN cases were classiied according to the 2003 ISN/RPS
classiication [5]. Data regarding immunoluorescence ind-
ings were available for 100% of the patients. Activity indices
(AIs) and chronicity indices (CIs) were calculated (maximum
Hindawi Publishing Corporation
International Journal of Nephrology
Volume 2015, Article ID 857316, 6 pages
http://dx.doi.org/10.1155/2015/857316