The Analysis Of The Pathology And Prognosis In Lupu Nephritis Combined With Acute Renal Injury

ObjectiveIn this study we assess clinicopathologic characteristics, treatment, curative effect and prognosis of acute kidney injury(AKI) in a large cohort of Chinese patients with lupus nephritis.MethodsThe clinical, laboratory, renal histopathology, treatment and outcome data were retrospectively collected and compared between lupus nephritis patients with and without AKI. The impact of AKI on renal outcome was evaluated.Results Among161patients with renal biopsy-proven lupus nephritis,69cases (42.9%) were identified as AKI. In comparison with the non-AKI group, patients with AKI had significantly lower base renal function, albumin level and Complement3levels(p<0.05), and most of them were in chronic kidney disease stage Ⅱ-Ⅲ (p<0.05); In comparison with the non-AKI group, the proportion of Type IV LN, Acute Activity Index, cell proliferation, cell or cell fibrous crescents, leukocyte infiltration, interstitial inflammatory cell infiltration, tubular atrophy, interstitial fibrosis and level of immunofluorescence C1q deposition in AKI group were higher (p<0.05); Comparing with the non-AKI group, patients with AKI group had no significantly different curative effect(p>0.05); Immunofluorescence Clq deposition was an independent risk factor for curative effect in AKI group (HR=4.574,95%CI1.507-13.883, p<0.05) and AKI was an independent risk factor affecting the efficacy of LN (HR=2.070,95%confidence interval1.114-3.846,p<0.05).ConclusionAcute kidney injury is common in lupus nephritis and is an independent risk factor for curative effect. Better controlling the progress of existing chronic kidney disease helped to prevent the occurrence of acute kidney injury. Type Ⅳ lupus nephritis prone to acute kidney injury, to understand the renal pathological C1q deposition levels could be useful to the judgement of curative effect of treatment and the prognosis of lupus nephritis.