The Association Between Erythrocyte Sedimentation Rate, C3, C4, Anti-dsDNA Levels, and Renal Disease Activity, Based on BILAG Index in Females With Lupus Nephritis

Abstract

Background: Systemic lupus erythematosus (SLE) is a chronic inflammatory disease that involves many organs, such as the kidneys. Females are most affected and early detection of renal disease activity is very important for morbidity and mortality reduction. Objectives: The aim of this study was to determine the relationships between ESR, C3, C4, and anti-dsDNA levels and renal disease activity, based on renal components of the British Isles lupus assessment group (BILAG) index, in females with lupus nephritis (LN). Methods: This study retrospectively reviewed the medical files of 150 females, diagnosed as LN, who were on routine follow-up at Hafez hospital lupus clinic located in Shiraz, Southern part of Iran (during years 2014 to 2015). The BILAG index score was extracted and data was analyzed (α = 0.05). Results: In all 150 females with SLE, the mean (SD) age was 37.1 (10.6) years. There were significant relationships between BILAG index score and higher ESR level (P value = 0.01), positive anti-dsDNA (P value < 0.001) and low C4 level (P value = 0.003), statistically. However, the results were not significant for mild level of ESR and low level of C3. Conclusions: This study confirmed that the BILAG index score was a valuable predictive index for renal disease involvement in females with LN; thus the authors suggest clinicians to use this index for better LN management.