| Objective: Analysis of the relationship between pathological and clinical characteristics of 406 patients with lupus nephritis(LN).Methods: To collect clinical manifestations,pathological data and laboratory indicators of 406 LN patients hospitalized in the Department of Nephrology at the Second Hospital of Hebei Medical University from January2010 to February 2018.Results:1.General clinical data:406 LN patients were enrolled in this study,of which there were 335 female patients(82.5%)and 71 male patients(17.5%),the male and female ratio was 1:4.7,the age of onset was 9 to 75 years old,median age 30 years old;renal biopsy age 14-75 years old,median age 31 years old.2.Pathological type:Type IV LN was the most common,accounting for36.9%,complex 31.3%,type III 17.2%,V type 8.1%,and type II least,accounting for 6.4%.There were 8 patients with LN combined with TMA,3patients with type III LN(37.5%),4 patients with type IV LN(50%),and 1patients with complex type LN(12.5%).3.Clinical classification:There were 273 patients(67.2%)of the first symptomatic LN with renal manifestations,of which the composite and type IV were significantly higher than the type III(74.8%,68% vs 47.1%).Nephrotic syndrome was the most common,accounting for 53.9%,more common in type IV,V type and compound type;followed by nephritis syndrome,accounting for 35.0%,more common in type III;asymptomatic type more common in type II;the incidence of type IV renal insufficiency is significantly higher than other types(P<0.01).4.Clinical manifestations:Extrarenal manifestations are most common with impaired blood systems,serositis,and fever.Type II LN had mild clinical manifestations and the incidence of hypertension was lower than other types(P<0.01).The incidence of type IV LN hematuria,anemia,and median serum creatinine were significantly higher than those of other types(P<0.01).The positive rate of type IV LN anti-ds DNA antibody(84.7%)and low C3incidence(98.7%)was significantly higher than other types(P<0.01).The incidence of type V LN low C3 and low C4 was significantly lower than other types(P<0.01).5.Activity Index:The IV LN type median AI and SLEDAI scores were significantly higher than other types(P<0.01);the compound median CI scores were significantly higher than other types(P<0.01).6.Correlation Analysis Results : Serum creatinine was positively correlated with AI and CI(P<0.01);serum creatinine was negatively correlated with albumin(P<0.05);serum creatinine was positively correlated with systolic blood pressure and 24-hour urinary protein(P<0.01).AI was negatively correlated with platelets count,C3 and C4.It was positively correlated with 24-hour urinary protein quantitation and SLEDAI(P<0.01).Serum creatinine was positively correlated with AI and CI(P<0.01).Conclusions:1.The pathological type of lupus nephritis in this group is mainly the proliferation type,among which type IV is the most common type,followed by compound type.2.The clinical features of LN has a certain correlation between the pathological classification.3.There is a certain correlation between LN pathological activity and clinical activity.4.Assessing the severity of LN in patients with pathological types and clinical features is important for further guidance of treatment and prognosis. |
