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Clinical Rheumatology

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01-05-2020 | Lupus Nephritis | Original Article

Clinicopathological factors for tubulointerstitial injury in lupus nephritis

Authors: Huang Lan-ting, Chen You-ming, Wei Li-xin, Wang Chen, Zheng Xiao-yan, He Hong-yan

Published in: Clinical Rheumatology | Issue 5/2020

Abstract

Objective

To investigate the incidence of tubulointerstitial injury in lupus nephritis (LN) and to examine clinicopathological factors that could indicate the presence of tubulointerstitial injury.

Methods

This study included 98 patients with LN. Clinical data and the pathological results of the initial renal biopsy were collected.

Results

The frequency of each tubulointerstitial injury parameter was over 50%, except for the interstitial edema, in the 98 patients investigated in this study. The most frequently detected tubulointerstitial injury parameter was tubular atrophy in this study. Neutrophil infiltration/karyorrhexis, wire loop lesion, and arteriosclerosis were observed frequently in patients with tubulointerstitial injuries. High serum creatinine and blood urea nitrogen (BUN) were observed more frequently in patients with tubulointerstitial injuries except tubular degeneration. The multivariable regression analysis showed a relationship between neutrophil infiltration/karyorrhexis and interstitial fibrosis/tubular degeneration, a relationship between wire loop lesion and tubulointerstitial inflammation/edema, and a relationship between arteriosclerosis and tubulointerstitial injuries (except interstitial edema). Patients with tubular degeneration had lower D-Dimer levels compared with those without. Patients with interstitial fibrosis had higher blood leukocyte counts than those without. The rate of low response to therapy was 13% among those without tubulointerstitial inflammation, but 35% in those with interstitial inflammation (P = 0.03).

Conclusion

Acute and chronic renal tubulointerstitial lesions are often found along with glomerular and vascular lesions. Immune and vascular factors are probably involved in tubulointerstitial injuries. Tubulointerstitial inflammation may be the initiator of chronic renal injury and may predict response to therapy.

Key Points
•To provide a theoretical basis for tubulointerstitial injury in LN.

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Title: Clinicopathological factors for tubulointerstitial injury in lupus nephritis
Authors: Huang Lan-ting
Chen You-ming
Wei Li-xin
Wang Chen
Zheng Xiao-yan
He Hong-yan
Publication date: 01-05-2020
Publisher: Springer London
Keywords: Lupus Nephritis
Edema
Arterial Occlusive Disease
Published in: Clinical Rheumatology / Issue 5/2020
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-019-04909-3

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