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S e p t e m b e r 0 6 - 0 7 , 2 0 1 8 | B a n g k o k , T h a i l a n d

allied

academies

Joint Event on

Global Women Health 2018 & Orthopedics Congress 2018

Archives of General Internal Medicine

ISSN: 2591-7951

Volume 2

BREAST CANCER, GYNECOLOGY AND WOMEN HEALTH

ORTHOPEDICS AND RHEUMATOLOGY

World Congress on

Annual Conference on

Arch Gen Intern Med 2018, Volume 2 | DOI: 10.4066/2591-7951-C3-009

IS RENAL BIOPSY AN ESSENTIAL TOOL FOR INITIATING TREATMENT IN

LUPUS NEPHRITIS; AN EXPERIENCE OF TERTIARY CARE CENTER IN NEPAL

Bartaula Bijay, Subedi Manish, Dhakal Sushil, Mudbhari Bandana, Tripathi Prashant Mani

and

Sharma Sanjib

Kumar

B P Koirala Institute of Health Sciences, Nepal

Introduction:

Lupus nephritis is one of the common complications of systemic lupus erythematosus. Timely treatment will decrease

progression to chronic kidney disease. Treatment varies with different stages for which biopsy is needed. Controversies still exists

regarding its requirement in management.

Methods:

Retrospective study from September 2014 to August 2016 in B P Koirala Institute of Health Sciences, Dharan, Nepal

among all patients with systemic lupus erythematosus and undergone renal biopsy.

Results:

Of 92 patients, most were female 85 (92.4%) with median age 32 years. In this study, 80.4% had some clinical

symptomatology. Of the clinical manifestations 41.3% had polyarthritis, edema (20.7%), malar rash (17.4%), ANA was positive in

80.4% and ds DNA in 70.7%. Renal biopsy showed a greater number of patients 27 (35%) h ad stage IV lupus nephritis, followed

by stage I, 19 (24%) and stage II, 16 (20%) lupus nephritis. Median urinary protein in class I was 1.05 gm, class II (0.63 gm), class

III (1.5 gm), class IV (2.44 gm), class V (3.99 gm) and class VI (4.7 gm). Only stage IV had kappa of 0.269 with p(0.003) showing

agreement between proteinuria and histological staging which was significant with p(<0.005). But overall kappa analysis showed

none to fair strength of agreement for different stages of lupus nephritis (-0.014-0.269) with proteinuria.

Conclusions:

Kappa (k) analysis showed none to fair strength of agreement for different stages of lupus nephritis and proteinuria.

So, only proteinuria is not enough to replace the need of renal biopsy in Lupus Nephritis.