Correlation of renal pathology of lupus nephritis with noninflammatory necrosis vasculopathy with its prognosis

Objective To analyze the correlation of renal pathology of lupus nephritis (LN) with noninflammatory necrotizing vasculopathy(NNV)with its prognosis. Methods A total of 35 patients, diagnosed with LN with MNV by undergoing renal biopsy and renal pathology from January 2008 to January 2016 in Department of Nephrology, the First Affiliated Hospital of the Army Medical University were selected, and divided into oligo-immune complex group(21 cases) and rich-immune complex group (14 cases). Log-rank (Mantel-Cox) test method was used to calculate renal survival rate. Results From the immune complex, pathological types, pathological features, treatment regimens and follow-up, immune complex deposition IgA (P<0.001), IgM (P<0.001), C3 (P<0.001) had statistically significant between the two groups.Renal pathology AI(Acute index) score (P=0.046),wire-loop lesion(P=0.031),nuclear fragmentation/microthrombi (P=0.017)were statistically different between the two groups. CI (Chronic index) score (P=0.007),renal tubular atrophy (P=0.038),renal interstitial fibrosis (P=0.014) had statistically significant difference between the two groups.During 3-year follow-up, renal survival rate in the oligo-immune complex group in the hormone + immunosuppressant regimen was lower(P=0.045), and there was no statistically significant difference between the two groups in the plasma exchange regimen (P>0.05). At the same time as intensive immunotherapy, the oligo-immune complex with AI ≥ 10 points had lower renal survival (P=0.044), oligo-immune complexes with CI ≥ 4 points also had lower renal survival rate (P=0.043). Conclusions In the renal pathology of LN with NNV, the treatment effect of oligo-immune complex depositionis poor and the renal survival rate is decreased.The survival rate of NNV oligo-immune complex is negatively correlated with AI and CI scores.