Diagnostic Determinants of Proliferative Lupus Nephritis Based on Clinical and Laboratory Parameters: A Diagnostic Study
Background: proliferative lupus nephritis (LN) has higher prevalence and worse prognosis than non-proliferative LN. Renal biopsy plays an important role in diagnosis and therapy of LN, but there are some obstacles in its implementation. A diagnostic scoring system for proliferative LN is necessary,...
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Interna Publishing
2018-06-01
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| Series: | Acta Medica Indonesiana |
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| Online Access: | https://www.actamedindones.org/index.php/ijim/article/view/579 |
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| author | Aida Lydia Mita Hafsah Saraswati Dharmeizar Dharmeizar Meilania Saraswati Siti Setiati |
| author_facet | Aida Lydia Mita Hafsah Saraswati Dharmeizar Dharmeizar Meilania Saraswati Siti Setiati |
| author_sort | Aida Lydia |
| collection | DOAJ |
| description | Background: proliferative lupus nephritis (LN) has higher prevalence and worse prognosis than non-proliferative LN. Renal biopsy plays an important role in diagnosis and therapy of LN, but there are some obstacles in its implementation. A diagnostic scoring system for proliferative LN is necessary, especially for cases in which renal biopsy cannot be performed. This study aimed to develop a diagnostic scoring system of proliferative LN based on its diagnostic determinants including hypertension, proteinuria, hematuria, eGFR, anti-dsDNA antibody, and C3 levels. Methods: a cross-sectional study with total sampling method was conducted. Our subjects were adult LN patients who underwent renal biopsy in Cipto Mangunkusumo Hospital between January 2007 and June 2017. Results: from a total of 191 subjects with biopsy-proven LN in this study, we found a proportion of proliferative LN of 74.8%. There were 113 subjects included for analysis of proliferative LN determinants. The multivariate analysis demonstrated that determinants for proliferative LN were hypertension (OR 3.39; 95% CI 1.30-8.84), eGFR <60ml/min/1.73m2 (OR 9.095; 95% CI 1.11-74.68), and low C3 levels (OR 3.97; 95% CI 1.41-11.17). After further analysis, we found that hypertension, eGFR <60ml/min/1.73m2, low C3 levels, and hematuria were essential components of the diagnostic scoring system on proliferative LN. The scoring system was tested with ROC curve and an AUC of 80.4% was obtained (95% CI 71.9-89). Conclusion: the proportion of proliferative LN in biopsy-proven LN patients of Cipto Mangunkusumo Hospital is 74.8%. Components of scoring system for proliferative LN consist of hypertension, eGFR <60ml/min/1.73m2, low C3 levels, and hematuria. |
| format | Article |
| id | doaj-art-cc5f2ef2f4f545beb7a68186554c6b0a |
| institution | Kabale University |
| issn | 0125-9326 2338-2732 |
| language | English |
| publishDate | 2018-06-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | Acta Medica Indonesiana |
| spelling | doaj-art-cc5f2ef2f4f545beb7a68186554c6b0a2025-08-20T03:25:52ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322018-06-01502Diagnostic Determinants of Proliferative Lupus Nephritis Based on Clinical and Laboratory Parameters: A Diagnostic StudyAida Lydia0Mita Hafsah Saraswati1Dharmeizar Dharmeizar2Meilania Saraswati3Siti Setiati4Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Pathology Anatomy, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaBackground: proliferative lupus nephritis (LN) has higher prevalence and worse prognosis than non-proliferative LN. Renal biopsy plays an important role in diagnosis and therapy of LN, but there are some obstacles in its implementation. A diagnostic scoring system for proliferative LN is necessary, especially for cases in which renal biopsy cannot be performed. This study aimed to develop a diagnostic scoring system of proliferative LN based on its diagnostic determinants including hypertension, proteinuria, hematuria, eGFR, anti-dsDNA antibody, and C3 levels. Methods: a cross-sectional study with total sampling method was conducted. Our subjects were adult LN patients who underwent renal biopsy in Cipto Mangunkusumo Hospital between January 2007 and June 2017. Results: from a total of 191 subjects with biopsy-proven LN in this study, we found a proportion of proliferative LN of 74.8%. There were 113 subjects included for analysis of proliferative LN determinants. The multivariate analysis demonstrated that determinants for proliferative LN were hypertension (OR 3.39; 95% CI 1.30-8.84), eGFR <60ml/min/1.73m2 (OR 9.095; 95% CI 1.11-74.68), and low C3 levels (OR 3.97; 95% CI 1.41-11.17). After further analysis, we found that hypertension, eGFR <60ml/min/1.73m2, low C3 levels, and hematuria were essential components of the diagnostic scoring system on proliferative LN. The scoring system was tested with ROC curve and an AUC of 80.4% was obtained (95% CI 71.9-89). Conclusion: the proportion of proliferative LN in biopsy-proven LN patients of Cipto Mangunkusumo Hospital is 74.8%. Components of scoring system for proliferative LN consist of hypertension, eGFR <60ml/min/1.73m2, low C3 levels, and hematuria.https://www.actamedindones.org/index.php/ijim/article/view/579determinantsproliferative lupus nephritisscoring systemSLEclinicopathology |
| spellingShingle | Aida Lydia Mita Hafsah Saraswati Dharmeizar Dharmeizar Meilania Saraswati Siti Setiati Diagnostic Determinants of Proliferative Lupus Nephritis Based on Clinical and Laboratory Parameters: A Diagnostic Study Acta Medica Indonesiana determinants proliferative lupus nephritis scoring system SLE clinicopathology |
| title | Diagnostic Determinants of Proliferative Lupus Nephritis Based on Clinical and Laboratory Parameters: A Diagnostic Study |
| title_full | Diagnostic Determinants of Proliferative Lupus Nephritis Based on Clinical and Laboratory Parameters: A Diagnostic Study |
| title_fullStr | Diagnostic Determinants of Proliferative Lupus Nephritis Based on Clinical and Laboratory Parameters: A Diagnostic Study |
| title_full_unstemmed | Diagnostic Determinants of Proliferative Lupus Nephritis Based on Clinical and Laboratory Parameters: A Diagnostic Study |
| title_short | Diagnostic Determinants of Proliferative Lupus Nephritis Based on Clinical and Laboratory Parameters: A Diagnostic Study |
| title_sort | diagnostic determinants of proliferative lupus nephritis based on clinical and laboratory parameters a diagnostic study |
| topic | determinants proliferative lupus nephritis scoring system SLE clinicopathology |
| url | https://www.actamedindones.org/index.php/ijim/article/view/579 |
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