Lupus Kidney Disease spectrum and Characteristics among Egyptian Adults and Children with SLE

Abstract

Objective: This research aimed to study the renal involvement among adults and children with systemic lupus erythematosus. Background: In addition to the glomerular affection "lupus Nephritis"(LN), there are other forms of lupus kidney disease; tubulointerstitial nephritis (TIN); vascular disease; and drug-induced renal disease can be found in Systemic Lupus Erythematosus (SLE) patients. Patient and Methods: A cross-sectional hospital-based study was conducted on 100 SLE patients (74 adults and 26 children) with presumed renal involvement. Patients were assessed clinically and by laboratory tests for renal involvement and renal biopsy findings were recorded to classify renal affection stage and type. Results: Clinically evident glomerular affection was present in 77% of adults and 80.7% of children. Tubulointerstitial nephritis (TIN) "associated with glomerular affection" in renal biopsy was demonstrated in 14% of adults and 11.5% of children, however TIN only" without glomerular affection" did not present in adults and presented in 11.5% of children. Thrombotic microangiopathy (TMA) was present in 2.7% of adults, but not present in children, anti-phospholipid nephropathy (APN) was present in 2.7% of adults and 7.7% of children. Cyclosporine induced acute kidney injury and nephropathy was reported in 2.7% of adults but not reported in children. Conclusion: Glomerular renal disease was the most common renal affection among adults and children with systemic lupus erythematosus and according to the non-glomerular affection, lupus associated tubulointerstitial nephritis and thrombotic microangiopathy were more common in adults than pediatrics. However; Antiphospholipid nephropathy was more common in pediatrics than adults.