Histologic evaluation of activity and chronicity of lupus nephritis and its clinical significance

Abstract

The National Institutes of Health (NIH) lupus nephritis activity and chronicity indices, which comprise six activity scores and four chronicity scores, have a long development history. The 2018 revised International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification for lupus nephritis adopted the most recent NIH indices to replace subclasses A, C, and A/C. Although an evidence-based approach should further evaluate the clinical significance of the modified NIH indices, recent validation studies demonstrated that the modified chronicity indices have a strong correlation with kidney outcome of lupus nephritis.

Kidney Biopsy and Immuno-Rheumatological Diseases: A Retrospective and Observational Study

“…It is well known that new SLE cases occur in patients between 15 and 40 years of age, with incidence being dramatically higher in the female than in the male gender [23]. Also, LN is present in at least 50% of SLE cases, presenting a classic "full house" staining pattern with simultaneous positivity on immunofluorescence for IgA, IgG, IgM, C3, C1q, and light chains [31].…”

Updates in renal pathology

“…The modified ISN/RPS classification was proposed in 2018, of which classes were simplified and histologic indices were added [ 4 ]. Choi et al [ 5 ] reviewed the 2018 ISN/RPS classification, especially the activity and chronicity indices, which were modified from the National Institutes of Health-sponsored 1983 classification, and the clinical significance of these histologic indices.…”