In patients with lupus nephritis, elevation in systolic blood pressure may predict development of tubulointerstitial lesions, which eventually lead to end-stage kidney disease.
Ruili Yuan, MMed, of Chengdu Second People’s Hospital in China, and colleagues used pathologic data from the first renal biopsy of 69 patients with lupus nephritis to study glomerular lesion, tubulointerstitial lesion, and arteriosclerotic lesion indices in relation to estimated glomerular filtration rate, blood pressure, and proteinuria. The investigators examined biopsy specimens with 10 or more glomeruli by light microscopy, immunofluorescence, and electron microscopy and evaluated them using the 2018 International Society of Nephrology and Renal Pathology Society (ISN/RPS) classification for lupus nephritis.
In multiple linear regressions, the investigators found that only tubulointerstitial lesion scores significantly correlated with kidney function and maximum systolic blood pressure in a linear fashion in patients with lupus nephritis.
“Although the initial causes are immune factors and globular lesions, there may be obvious interstitial damage when hypertension persists,” Dr Yuan’s team wrote in Kidney and Blood Pressure Research. “Hypertension indicates the interstitial damage downstream.”
The investigators noted that hypertension is prevalent among patients with lupus nephritis, especially in those with proliferative disease.
Yuan R, Zhong Y, Zeng Y, Zhang J. Correlation between tubulointerstitial lesion and blood pressure in lupus nephritis patients: a pathological, retrospective study. Kidney Blood Press Res. 2022;47(6):391-398. doi:10.1159/000523793