Performance of Clinical and Biochemical Parameters in Identifying Renal Histopathology and Predictors of One-Year Renal Outcome in Lupus Nephritis—A Single Centre Study from India
<b>Objectives:</b> To assess the performance of clinical and biochemical parameters in identifying renal histopathology. To assess the performance of a combination of demographic, clinical, serological and histopathological parameters in determining renal response at one year. <b>M...
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MDPI AG
2022-12-01
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| author | Aishwarya Gopal Chengappa Kavadichanda Devender Bairwa Sanket Shah Sonal Mehra Bheemanathi Hanuman Srinivas Christina Mary Mariaselvam Molly Mary Thabah Vir Singh Negi |
| author_facet | Aishwarya Gopal Chengappa Kavadichanda Devender Bairwa Sanket Shah Sonal Mehra Bheemanathi Hanuman Srinivas Christina Mary Mariaselvam Molly Mary Thabah Vir Singh Negi |
| author_sort | Aishwarya Gopal |
| collection | DOAJ |
| description | <b>Objectives:</b> To assess the performance of clinical and biochemical parameters in identifying renal histopathology. To assess the performance of a combination of demographic, clinical, serological and histopathological parameters in determining renal response at one year. <b>Methods:</b> Data of biopsy-proven (ISN/RPS—2003 criteria) Lupus Nephritis (LN) were extracted from the institute database. Demographic, clinical and biochemical parameters at the time of biopsy were noted, and their associations with histopathological class, activity and chronicity scores were evaluated. Follow-up data at one year were collected. Complete, partial or no response (CR, PR, NR) for renal outcomes at one year and the predictors of NR were assessed. <b>Results:</b> Out of the 333 renal biopsies, 240 (71.8%) were Class III/IV. More patients with Class III/IV LN had hypertension (52.1%) and low eGFR (<i>p</i> < 0.001). Among Class III/IV, AS correlated weakly with UPCR (r = 0.31, <i>p</i> < 0.01), eGFR (r = −0.172; <i>p</i> < 0.01) and CS with eGFR (r = −0.212; <i>p</i> < 0.01). The presence of either hypertension, UPCR > 0.5 g/day, active urinary sediments or serum creatinine >1.3 g/dL had a sensitivity of >96% and specificity of <9% in detecting proliferative LN, crescents, interstitial inflammation and chronicity. NR was higher in males (aOR:3.9, 95% CI:1.4–11.0, <i>p</i> < 0.001), those with abnormal baseline creatinine (aOR: 1.9, 95% CI: 1.1–3.2, <i>p</i> < 0.001), higher renal SLEDAI (<i>p</i> < 0.05), higher AS, CS (<i>p</i> < 0.001) and interstitial inflammation (<i>p</i> < 0.005). In the binary logistic regression, the combination of male sex, baseline creatinine, UPCR and CS performed best in predicting NR (AUC: 0.762; 95% CI: 0.684–0.840, <i>p</i> < 0.001). <b>Conclusions:</b> Clinical and biochemical parameters alone have a poor specificity in identifying renal histopathology. A combination of demographic, clinical and histopathology parameters can better predict renal outcomes at one year. |
| first_indexed | 2024-03-09T17:08:12Z |
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| id | doaj.art-40f750d7f8bd44b988aa0beb6d04673f |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T17:08:12Z |
| publishDate | 2022-12-01 |
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| series | Diagnostics |
| spelling | doaj.art-40f750d7f8bd44b988aa0beb6d04673f2023-11-24T14:19:47ZengMDPI AGDiagnostics2075-44182022-12-011212316310.3390/diagnostics12123163Performance of Clinical and Biochemical Parameters in Identifying Renal Histopathology and Predictors of One-Year Renal Outcome in Lupus Nephritis—A Single Centre Study from IndiaAishwarya Gopal0Chengappa Kavadichanda1Devender Bairwa2Sanket Shah3Sonal Mehra4Bheemanathi Hanuman Srinivas5Christina Mary Mariaselvam6Molly Mary Thabah7Vir Singh Negi8Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, IndiaDepartment of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, IndiaDepartment of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, IndiaDepartment of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, IndiaDepartment of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, IndiaDepartment of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, IndiaDepartment of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, IndiaDepartment of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, IndiaDepartment of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India<b>Objectives:</b> To assess the performance of clinical and biochemical parameters in identifying renal histopathology. To assess the performance of a combination of demographic, clinical, serological and histopathological parameters in determining renal response at one year. <b>Methods:</b> Data of biopsy-proven (ISN/RPS—2003 criteria) Lupus Nephritis (LN) were extracted from the institute database. Demographic, clinical and biochemical parameters at the time of biopsy were noted, and their associations with histopathological class, activity and chronicity scores were evaluated. Follow-up data at one year were collected. Complete, partial or no response (CR, PR, NR) for renal outcomes at one year and the predictors of NR were assessed. <b>Results:</b> Out of the 333 renal biopsies, 240 (71.8%) were Class III/IV. More patients with Class III/IV LN had hypertension (52.1%) and low eGFR (<i>p</i> < 0.001). Among Class III/IV, AS correlated weakly with UPCR (r = 0.31, <i>p</i> < 0.01), eGFR (r = −0.172; <i>p</i> < 0.01) and CS with eGFR (r = −0.212; <i>p</i> < 0.01). The presence of either hypertension, UPCR > 0.5 g/day, active urinary sediments or serum creatinine >1.3 g/dL had a sensitivity of >96% and specificity of <9% in detecting proliferative LN, crescents, interstitial inflammation and chronicity. NR was higher in males (aOR:3.9, 95% CI:1.4–11.0, <i>p</i> < 0.001), those with abnormal baseline creatinine (aOR: 1.9, 95% CI: 1.1–3.2, <i>p</i> < 0.001), higher renal SLEDAI (<i>p</i> < 0.05), higher AS, CS (<i>p</i> < 0.001) and interstitial inflammation (<i>p</i> < 0.005). In the binary logistic regression, the combination of male sex, baseline creatinine, UPCR and CS performed best in predicting NR (AUC: 0.762; 95% CI: 0.684–0.840, <i>p</i> < 0.001). <b>Conclusions:</b> Clinical and biochemical parameters alone have a poor specificity in identifying renal histopathology. A combination of demographic, clinical and histopathology parameters can better predict renal outcomes at one year.https://www.mdpi.com/2075-4418/12/12/3163chronic kidney diseaseSLELupus Nephritisproteinuriahistopathologyprognosis |
| spellingShingle | Aishwarya Gopal Chengappa Kavadichanda Devender Bairwa Sanket Shah Sonal Mehra Bheemanathi Hanuman Srinivas Christina Mary Mariaselvam Molly Mary Thabah Vir Singh Negi Performance of Clinical and Biochemical Parameters in Identifying Renal Histopathology and Predictors of One-Year Renal Outcome in Lupus Nephritis—A Single Centre Study from India Diagnostics chronic kidney disease SLE Lupus Nephritis proteinuria histopathology prognosis |
| title | Performance of Clinical and Biochemical Parameters in Identifying Renal Histopathology and Predictors of One-Year Renal Outcome in Lupus Nephritis—A Single Centre Study from India |
| title_full | Performance of Clinical and Biochemical Parameters in Identifying Renal Histopathology and Predictors of One-Year Renal Outcome in Lupus Nephritis—A Single Centre Study from India |
| title_fullStr | Performance of Clinical and Biochemical Parameters in Identifying Renal Histopathology and Predictors of One-Year Renal Outcome in Lupus Nephritis—A Single Centre Study from India |
| title_full_unstemmed | Performance of Clinical and Biochemical Parameters in Identifying Renal Histopathology and Predictors of One-Year Renal Outcome in Lupus Nephritis—A Single Centre Study from India |
| title_short | Performance of Clinical and Biochemical Parameters in Identifying Renal Histopathology and Predictors of One-Year Renal Outcome in Lupus Nephritis—A Single Centre Study from India |
| title_sort | performance of clinical and biochemical parameters in identifying renal histopathology and predictors of one year renal outcome in lupus nephritis a single centre study from india |
| topic | chronic kidney disease SLE Lupus Nephritis proteinuria histopathology prognosis |
| url | https://www.mdpi.com/2075-4418/12/12/3163 |
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