The epidemiology of Acute renal failure in Scotland; the ...



Quantitative morphometric analysis of Lupus Nephritis reveals the prognostic significance of interstitial infiltrate, tubular atrophy, but not scarring

Hunter M, Bellamy C, Duffield JS

MRC Centre for Inflammation Research, Department of Pathology, Medical School, University of Edinburgh

The WHO Criteria for Lupus nephritis have proved useful in predicting progression in those with Class IV disease. However, for those with class III or V disease the predictive power of the criteria is less clear. Further, some patients with class IV nephritis have benign disease. Decisions based solely on these criteria are weighty since they involve cytotoxic therapy in young patients. Because of the obvious deficiencies in current histological criteria and associated interstitial disease in lupus nephritis, other subjective criteria have been assessed such as activity and chronicity indices. The predictive power has proved variable. With the advent of digital image technology we have devised four economical, quick, but robust, reproducible and entirely objective assays for assessing polymeric collagen, collagenous matrix, inflammatory infiltrate and tubular space in whole biopsies. First renal biopsies and data were collected retrospectively on all patients with Lupus presenting to a single nephrology centre over 15 years. The biopsy-derived data and clinical outcomes were compared.

Increased tubular space predicated doubling of creatinine with time (P ................
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