A STUDY ON CORRELATION BETWEEN LEVEL OF PROTEINURIA AND DIFFERENT CLASSES OF LUPUS NEPHRITIS IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS ADMITTED IN A TERTIARY CARE HOSPITAL IN EASTERN INDIA

Dr. Boudhayan Bhattacharjee, *Dr. Arindam Naskar, Dr. Sudeshna Mallik, DR. Anuradha De (Pati) and Prof. Bibhuti Saha

ABSTRACT

Background: Systemic lupus erythematosus is an auto-immune condition where renal involvement is an important predictive marker of mortality which mainly occurs in first decade of the disease. Objective: Aim of this study was to diagnose lupus nephritis early and to correlate the extent of renal involvement with different levels of proteinuria. Method: In this single center, cross-sectional study in the year 2015-2017 total 32(thirty-two) cases were taken as cases of SLE, diagnosed according to Current Systemic Lupus International Collaborating Clinic Criteria For Classification Of Systemic Lupus Erythematosus and all underwent 24 hours urinary protein estimation followed by renal biopsy. Results: A weak positive correlation was found between level of proteinuria and classes of lupus nephritis (correlation co- efficient 0.259; 95% CI -0.09866 to 0.5573; significance level 0.0152). Best cut-off value for proteinuria for doing renal biopsy to detect high grade lupus nephritis (class III or higher) using the ROC curve was found to be 234 mg (sensitivity 88.00% and specificity 71.43%). Our study found that 65% of the patients had class IV lupus nephritis [class IV B > class IV A] followed by class II (22%), class V (9%) and Class III (3%). Conclusion: So, a SLE patient presenting with more than 234 mg of protein in 24 hours urinary sample should undergo renal biopsy for early detection of high grade lupus nephritis which will need higher immunosuppressive therapy.

Keywords: Proteinuria, Renal Biopsy, Lupus Nephritis.