Clinical Significance of Renal Interstitial Fibrosis in Patients with Lupus Nephritis

Abstract

Objective: Authorized pathological classification schemes pay much attention to glomerular changes but little to renal interstitial injuries in patients with lupus nephritis (LN). Since the degree of interstitial injury may be a better renal predictor than glomerular damage in some chronic glomerular diseases, we explored the clinical significance of interstitial fibrosis in the prognosis of LN.
Materials: Forty-three patients of systemic lupus erythematosus (SLE) who had undergone renal biopsy were enrolled in the present study.
Methods: All patients were categorized using the International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification and their interstitial fibrosis severity was semi-quantitatively graded. Clinical data was evaluated at the time of renal biopsy and at the last follow-up period.
Results: In each group classified by the ISN/RPS classification, renal function had no statistical difference at both times. When all patients were divided into interstitial fibrosis grades, there was no significant difference in renal function at the time of renal biopsy. However, renal function in patients with severe fibrosis at the last follow-up period was significantly worse than those in other fibrosis grades. On the other hand, the serological activity of SLE had significantly ameliorated after treatments in both categorizations.
Conclusion: It is concluded that severe interstitial fibrosis may be a renal predictor apart from glomerular lesions and the serological activity of SLE.