Abstract:

ABSTRACT Objective: To investigated the clinical, histological characteristics and outcomes of SLE patients with lupus podocytopathy．Methodology: 53 SLE cases with renal involvement and biopsy-proven lupus podocytopathy were collected. Their clinical，immunological pathological features and prognosis were retrospectively analyzed．Results: The patients with lupus podocytopathy accounted for 1.41% of lupus nephritis patients in the same period. 50 cases presented as nephrotic syndrome in which 17 cases were complicated by acute kidney injury(AKI). Pathological manifestation under LM showed mesangial proliferation (MP) in 31 patients, minimal change disease(MCD) in 13 and focal segmental glomerulonephritis（FSGS）in 9.The incidence of AKI was much higher in FSGS group than in MCD and MP group (P<0.01).Compared with MCD group,the ratio of low serum C3 level was significantly higher in MP and FSGS group(P<0.01). 69.8% of all cases received complete remission(CR) undering induction treatment of glucocorticoid or steroids in combination with immune depressant.The CR rate in FSGS group was much lower than in the other two groups(P<0.01). 29 cases(54.7%) relapsed during follow-up. 13 patients had repeat renal biopsy while histological transition was found in 6 . No patient progressed to end stage renal failure or death. Conclusion: Lupus podocytopathy is characterised by nephrotic syndrome ,often complicated by AKI，and different histologic changes including MCD, MP and FSGS. It has high remission rate and benign prognosis, but easy to relapse. Patients with FSGS showed more serious renal lesion and worse therapeutic response.

Key words:  lupus nephritis, podocytopathy, pathological, classification, prognosis