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Utility of renal resistive index measurement in juvenile systemic lupus erythematosus: a cross-sectional single-center study

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Abstract

Introduction

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease with a complex etiopathogenesis. Renal involvement is the most common and devastating complication of the disease. Renal resistive index (RRI) was suggested as a noninvasive biomarker for lupus nephritis in previous studies. This is the first study to investigate the role of RRI measurement in juvenile SLE patients.

Methods

This cross-sectional study included 25 juvenile SLE patients and 25 healthy controls. Demographic and clinical features were recruited from the medical files of the patients. RRI measurements were performed with color Doppler ultrasonography from intrarenal arteries when Doppler angles were 30–60 in right and left kidneys.

Results

Of 25 (19 female, 6 male) SLE patients, nineteen (76%) patients had urinary abnormalities during follow-up, and renal biopsy was performed in 14 patients, of which 9 (64.3%) had class 2 and 5 (35.7%) had class 4 lupus nephritis. RRI was found significantly higher in SLE group than healthy controls. RRI did not differ between SLE patients, grouped according to the presence of renal involvement and class IV lupus nephritis. RRI did not correlate with serum creatinine, GFR, spot urine protein/creatinine, and albumin/creatinine ratio.

Conclusions

Although RRI was found significantly higher in juvenile SLE, it is not affected by GFR, proteinuria level, or the renal biopsy results, even the presence of proliferative nephritis. The underlying pathogenetic mechanisms of increased RRI in SLE should be clarified in further studies.

Key Points

• Renal resistive index (RRI) is a parameter derived from renal Doppler ultrasound imaging and shows the intrarenal arterial resistance.

• This study reveals that RRI is increased in juvenile systemic lupus erythematosus.

• RRI was previously related with renal involvement, particularly class 4 lupus nephritis in adults. However, RRI was not affected by the presence or degree of renal involvement in juvenile SLE patients in our study.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

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Authors and Affiliations

  1. Department of Pediatric Rheumatology, Adana City Training and Research Hospital, Adana, 01331, Turkey

    Rabia Miray Kisla Ekinci

  2. Department of Radiology, Adana City Training and Research Hospital, Adana, 01331, Turkey

    Burcak Cakir Pekoz

  3. Department of Pediatric Nephrology, Adana City Training and Research Hospital, Adana, 01331, Turkey

    Sevgin Taner

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  1. Rabia Miray Kisla Ekinci
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  2. Burcak Cakir Pekoz
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  3. Sevgin Taner
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Contributions

RMKE conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. ST and BCP collected data, carried out the initial analyses, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. All co-authors take full responsibility for the integrity of the study.

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Correspondence to Rabia Miray Kisla Ekinci.

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Kisla Ekinci, R.M., Cakir Pekoz, B. & Taner, S. Utility of renal resistive index measurement in juvenile systemic lupus erythematosus: a cross-sectional single-center study. Clin Rheumatol 42, 2849–2854 (2023). https://doi.org/10.1007/s10067-023-06711-8

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  • DOI: https://doi.org/10.1007/s10067-023-06711-8

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