{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:12:31Z","timestamp":1777929151617,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Current rheumatology and nephrology society guidelines in lupus nephritis do not recommend renal biopsy for proteinuria of less than 500\u00a0mg\/24\u00a0h. This might lead to a significant delay in the early diagnosis of lupus nephritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The main aim of this study is to determine the nature of renal lesions in patients with low-grade proteinuria and to analyze the predictors for clinically significant lupus nephritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a single-center, retrospective study. All consecutive patients of lupus nephritis, with low-grade proteinuria (200\u00a0mg to 500\u00a0mg\/24\u00a0h) undergoing renal biopsy were enrolled in this study. The renal biopsies were classified into significant lesions (Class III\/IV\/V) and non-significant lesions (Class I and II). Treatment na\u00efve groups and treatment-modified groups were analyzed separately. Predictive factors for significant renal lesions were determined by univariate and multivariate analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 183 patients of lupus with proteinuria between 200 and 500\u00a0mg \/ 24\u00a0h. Mean (SD) age was 30.2 (11.39) years with 167 (91.2%) of them being females. The mean (SD) baseline proteinuria was 351.03 (98.1) mg\/24\u00a0h 85 patients (46.5%) had proliferative lupus nephritis where whereas 17 patients (9.3%) had membranous nephropathy. Crescents and fibrinoid necrosis were seen in 10 (5.46%) and 24 (13.11 %) patients respectively. Isolated proteinuria without any other sediments was seen in 95 patients (51.9%) of which 29 patients had proliferative lupus nephritis. Elevated Anti-double stranded DNA (anti-dsDNA), low C3, low C4 and the presence of urinary sediments were significantly associated with significant renal lesions in biopsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Significant renal lesions were seen in around half of the patients with low-grade proteinuria underscoring the importance of performing a renal biopsy in this set of patients. Low C3 and C4, urinary sediments, and elevated anti-dsDNA were predictors for significant renal lesions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033241289806","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T14:04:09Z","timestamp":1727964249000},"page":"1511-1517","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Does the standard proteinuria cut-off for renal biopsy in lupus nephritis as per the current guidelines hold good for Asian population? A single-centre study from South India"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5369-7062","authenticated-orcid":false,"given":"Shivraj","family":"Padiyar","sequence":"first","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Christian Medical College Vellore, Vellore, India"},{"name":"Department of Clinical Immunology and Rheumatology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandu","family":"AS","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Christian Medical College Vellore, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahasampath","family":"Gowri","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Christian Medical College Vellore, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Mathew","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Christian Medical College Vellore, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,10,3]]},"reference":[{"key":"bibr1-09612033241289806","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24431"},{"key":"bibr2-09612033241289806","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kev311"},{"key":"bibr3-09612033241289806","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23887"},{"key":"bibr4-09612033241289806","doi-asserted-by":"publisher","DOI":"10.1002\/art.21955"},{"key":"bibr5-09612033241289806","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V102413"},{"key":"bibr6-09612033241289806","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfs073"},{"key":"bibr7-09612033241289806","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21664"},{"key":"bibr8-09612033241289806","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201940"},{"key":"bibr9-09612033241289806","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.09.001"},{"key":"bibr10-09612033241289806","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.180145"},{"key":"bibr11-09612033241289806","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.09.007"},{"issue":"2","key":"bibr12-09612033241289806","first-page":"332","volume":"34","author":"Christopher-Stine 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