The evaluation of the results of nephrobiopsies in patients with lupus nephritis

Lupus nephritis is characterized by a variety of clinical and morphological manifestations. Histological changes in the renal tissue often determine the course and prognosis of the disease. The performance of nephrobiopsy provides an important information about the morphological changes in the kidne...

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Main Authors: N.F. Soroka, M.V. Dmitrieva, V.A. Rabtsevich
Format: Article
Language:English
Published: Vitebsk State Order of Peoples’ Friendship Medical University 2023-04-01
Series:Вестник Витебского государственного медицинского университета
Subjects:
Online Access:https://vestnik.vsmu.by/downloads/2023/2/2023_22_2_35-46.pdf
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author N.F. Soroka
M.V. Dmitrieva
V.A. Rabtsevich
author_facet N.F. Soroka
M.V. Dmitrieva
V.A. Rabtsevich
author_sort N.F. Soroka
collection DOAJ
description Lupus nephritis is characterized by a variety of clinical and morphological manifestations. Histological changes in the renal tissue often determine the course and prognosis of the disease. The performance of nephrobiopsy provides an important information about the morphological changes in the kidneys and their severity. Objectives. To evaluate histological changes in the renal tissue determined by kidney biopsy in patients with systemic lupus erythematosus. Material and methods. We analyzed 191 specimens of renal biopsy from 161 patients with systemic lupus erythematosus. Examination was conducted using light and immunofluorescent microscopy. Results. The most significant signs of the inflammatory process and sclerotic changes in the renal tissue were revealed in class IV: the presence of crescents (p<0.001), activation of podocytes, proliferation of mesangial cells, splitting of the basement membrane and the presence of deposits, swelling and proliferation of endotheliocytes (p=0.01), detection of fibrin microthrombi (p=0.04), lymphoid infiltration of interstitial tissue (p<0.001), segmental sclerosis of glomeruli, synechia with a capsule (p=0.001), atrophy and necrosis of tubular epithelium (p=0.05), sclerosis of interstitial tissue. In class III, these manifestations were less significant. Individuals with morphological class VI of lupus nephritis had the marked signs of sclerotic changes (global glomerulosclerosis, sclerosis of interstitial tissue (p=0.002), damage of the renal arteries), degeneration/atrophy of tubulocytes, and lymphoid infiltration of interstitial tissue (p<0.001). Class II is characterized by expansion of the mesangial matrix and proliferation of mesangial cells (p<0.001), while class V is characterized by thickening of the basement membrane of glomerular capillaries (p<0.001). Conclusions. In the kidney tissue samples proliferative classes of lupus nephritis were the most frequent type of lesion (83.7%), especially morphological class IV (51.1%), which has the most significant inflammatory and sclerotic changes in the renal tissue. An activity index was 9.6 ± 0.5 points (p<0.001), chronicity index was 3.9±0.3 points (p<0.001).
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spelling doaj.art-8f3378a609a841c7963136bfcbfc972c2024-02-02T11:33:53ZengVitebsk State Order of Peoples’ Friendship Medical UniversityВестник Витебского государственного медицинского университета1607-99062312-41562023-04-01222354610.22263/2312-4156.2023.2.35The evaluation of the results of nephrobiopsies in patients with lupus nephritisN.F. Soroka0M.V. Dmitrieva1V.A. Rabtsevich2Belarusian State Medical University, Minsk, Republic of BelarusBelarusian State Medical University, Minsk, Republic of BelarusBelarusian State Economic University, Minsk, Republic of Belarus Lupus nephritis is characterized by a variety of clinical and morphological manifestations. Histological changes in the renal tissue often determine the course and prognosis of the disease. The performance of nephrobiopsy provides an important information about the morphological changes in the kidneys and their severity. Objectives. To evaluate histological changes in the renal tissue determined by kidney biopsy in patients with systemic lupus erythematosus. Material and methods. We analyzed 191 specimens of renal biopsy from 161 patients with systemic lupus erythematosus. Examination was conducted using light and immunofluorescent microscopy. Results. The most significant signs of the inflammatory process and sclerotic changes in the renal tissue were revealed in class IV: the presence of crescents (p<0.001), activation of podocytes, proliferation of mesangial cells, splitting of the basement membrane and the presence of deposits, swelling and proliferation of endotheliocytes (p=0.01), detection of fibrin microthrombi (p=0.04), lymphoid infiltration of interstitial tissue (p<0.001), segmental sclerosis of glomeruli, synechia with a capsule (p=0.001), atrophy and necrosis of tubular epithelium (p=0.05), sclerosis of interstitial tissue. In class III, these manifestations were less significant. Individuals with morphological class VI of lupus nephritis had the marked signs of sclerotic changes (global glomerulosclerosis, sclerosis of interstitial tissue (p=0.002), damage of the renal arteries), degeneration/atrophy of tubulocytes, and lymphoid infiltration of interstitial tissue (p<0.001). Class II is characterized by expansion of the mesangial matrix and proliferation of mesangial cells (p<0.001), while class V is characterized by thickening of the basement membrane of glomerular capillaries (p<0.001). Conclusions. In the kidney tissue samples proliferative classes of lupus nephritis were the most frequent type of lesion (83.7%), especially morphological class IV (51.1%), which has the most significant inflammatory and sclerotic changes in the renal tissue. An activity index was 9.6 ± 0.5 points (p<0.001), chronicity index was 3.9±0.3 points (p<0.001).https://vestnik.vsmu.by/downloads/2023/2/2023_22_2_35-46.pdfsystemic lupus erythematosuslupus nephritisnephrobiopsylight microscopyimmunofluorescence microscopy
spellingShingle N.F. Soroka
M.V. Dmitrieva
V.A. Rabtsevich
The evaluation of the results of nephrobiopsies in patients with lupus nephritis
Вестник Витебского государственного медицинского университета
systemic lupus erythematosus
lupus nephritis
nephrobiopsy
light microscopy
immunofluorescence microscopy
title The evaluation of the results of nephrobiopsies in patients with lupus nephritis
title_full The evaluation of the results of nephrobiopsies in patients with lupus nephritis
title_fullStr The evaluation of the results of nephrobiopsies in patients with lupus nephritis
title_full_unstemmed The evaluation of the results of nephrobiopsies in patients with lupus nephritis
title_short The evaluation of the results of nephrobiopsies in patients with lupus nephritis
title_sort evaluation of the results of nephrobiopsies in patients with lupus nephritis
topic systemic lupus erythematosus
lupus nephritis
nephrobiopsy
light microscopy
immunofluorescence microscopy
url https://vestnik.vsmu.by/downloads/2023/2/2023_22_2_35-46.pdf
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