A Study on Clinical and Laboratory Status of Active and Inactive LN Patients

Abstract

Background: Lupus nephritis (LN) is a significant manifestation of systemic lupus erythematosus (SLE) that affects the kidneys. Differentiating between active and inactive LN is essential for determining disease activity, tailoring treatment strategies, and monitoring patient outcomes. The clinical and laboratory status of LN patients provides valuable insights into the severity of renal involvement, response to treatment, and the potential for disease progression. Objective: To asses clinical and laboratory status of active and inactive LN patients. Method: This cross sectional study was conducted in the Department of Nephrology, Dhaka Medical College Hospital, Dhaka from January, 2017 to June, 2018. This cross sectional study was performed on 60 biopsy proven lupus nephritis patients and 30 age and sex matched apparently healthy control subjects. All the patients were recruited as per inclusion and exclusion criteria. Diagnosed SLE patients who had renal involvement and undergone renal biopsy for standard clinical indications were recruited by purposive sampling and divided into two groups of active and inactive LN as per operational definition. Results: During the study, Mean age of the lupus nephritis patients in active and inactive LN was 26.60 ± 8.36 years and 28.80 ± 9.18 years respectively. Most of the patients in both groups were female. Anaemia and edema was observed significantly higher in active than that of inactive lupus nephritis. Systolic and diastolic blood pressure was significantly higher in active lupus nephritis than that of inactive lupus nephritis patients. Hb, serum C3 and eGFR were significantly lower in active LN than that of inactive LN. RBC, WBC, platelet count were also lower in active LN than that of inactive LN but no significant difference was observed between two groups. ESR, serum creatinine, proteinuria, Anti ds DNA Ab titre and uMCP-1 were significantly higher in active LN than that of inactive LN. There was no difference between active and inactive LN patients with regards the use of medications. There was no difference in renal biopsy classes in between two groups. Conclusion: According to our study findings, active lupus nephritis (LN) patients exhibited elevated systolic and diastolic blood pressure compared to those with inactive LN. Additionally, active LN patients displayed lower levels of hemoglobin, serum C3, and estimated glomerular filtration rate (eGFR) compared to inactive LN patients. While red blood cell (RBC), white blood cell (WBC), and platelet counts were also lower in active LN patients, the difference between the two groups did not reach statistical significance. Furthermore, there were no notable differences in medication usage between active and inactive LN patients, and the distribution of renal biopsy classes was similar in both groups.