title: Analysis of clinicopathologic correlations in Iranian patients with lupus nephritis.
abstract: OBJECTIVE
  To determine clinical features of different histopathological presentations in patients with lupus nephritis (LN).
  
  
  METHODS
  Clinical and pathological features of 71 biopsy-proven LN patients were analyzed in a cross-sectional study during 2005-2011.
  
  
  RESULTS
  Sixty-five women (91.5%) and six men (8.5%) were studied. The mean Activity Index (AI) and Chronicity Index (CI) were 6.2 ± 3.1 and 1.7 ± 1.5, respectively. The most common histopathologic presentation of kidneys was class IV (52.1%). Patients with more advanced International Society of Nephrology and the Renal Pathology Society (ISN/RPS) classes, had longer disease duration (P = 0.007), higher levels of blood urea nitrogen (P = 0.004) and serum creatinine (P = 0.035). The most frequent active lesion seen in renal biopsies was endocapillary hypercellularity (83.1%) while glomerular sclerosis was the most common chronic lesion (52.1%). Patients with chronic lesions, including glomerular sclerosis (P = 0.032), fibrous crescent (P = 0.001), interstitial fibrosis (P = 0.025) and tubular atrophy (P = 0.049) had higher serum creatinine levels. Hypertension was mainly seen in patients who had interstitial fibrosis and tubular atrophy (P = 0.026, 0.002 respectively). Moreover, subjects with renal failure had been more frequently involved with fibrinoid necrosis/karyorrhexis (P = 0.003), interstitial inflammation (P = 0.009), fibrous crescents (P = 0.041), tubular atrophy (P = 0.008) and interstitial fibrosis (P < 0.001).
  
  
  CONCLUSIONS
  We found that both histopathologic classification (ISN/RPS criteria) and histopathologic grading (US National Institutes of Health activity and chronicity indices) correlate to some clinical manifestations of LN. Considering these correlations may help to determine the patients' clinicopathologic status, prognosis and the need to immediate treatment. Nevertheless, it is necessary to clarify the accuracy of these findings in larger-scale prospective studies.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Rheumatic Diseases Research Center (RDRC), Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Zhaleh
authors.initials: Z
authors.lastname: Shariati-Sarabi
authors.forename: Amin
authors.initials: A
authors.lastname: Ranjbar
authors.forename: Seyed M
authors.initials: SM
authors.lastname: Monzavi
authors.forename: Habibollah
authors.initials: H
authors.lastname: Esmaily
authors.forename: Mehdi
authors.initials: M
authors.lastname: Farzadnia
authors.forename: Abbas A
authors.initials: AA
authors.lastname: Zeraati
mesh_terms: D000328:Adult; D001284:Atrophy; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D001806:Blood Urea Nitrogen; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005355:Fibrosis; D005919:Glomerular Filtration Rate; D005921:Glomerulonephritis / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007492:Iran; D007668:Kidney / Q000473:pathology* / Q000503:physiopathology; D008181:Lupus Nephritis / Q000097:blood / Q000145:classification / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D051437:Renal Insufficiency / Q000175:diagnosis / Q000473:pathology; D012598:Sclerosis; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003404:Creatinine
keywords: Activity Index; Chonicity Index; ISN/RPS classification; SLE; lupus nephritis