Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Introduction: Lupus nephritis is the most common complication in Juvenile Systemic Lupus Erythematosus (JSLE). This study aimed to assess the relationship between Renal Resistive Index (RRI) of renal and intrarenal arteries and different histological and clinical features of Lupus Nephritis. Methods: The Renal Resistive Index of Interlobar, Arcuate and Hilar arteries were measured in 50 JSLE patients, 80% of patients of the group were diagnosed with Lupus Nephritis. The medical history, Blood Pressure readings, renal function labs and SLIDAI-2K score were assessed at the time of the radiological study. Results: A significant negative correlation between RRI of different renal arteries and GFR (r -0.378, p 0.007; r -0.431, p0.002) was found.There was a negative correlation (r -0.292, p 0.040) between RRI of left Interlobar artery with the duration of management with Angiotensin Converting Enzyme Inhibitors (ACEI); and a negative correlation between left Interlobar artery and Hydroxychloroquine (r -0.322, p0.023).The Median of RRI of the 3 measured arteries was highest in class V and class IV (0.67, 0.58) but with no statistical correlation. Also, The median of RRI in patients with fibrosis (0.559 - 0.565) reported in their biopsy was higher than patients without fibrosis (0.539 -0.535) but with no statistical significant (0.20-0.37).There was no statistical significant correlation between RRI and SLEDAI-2K, SLEDAI-R or Damage Index. Conclusion: RRI value is affected by systemic hemodynamics and tone of renal arterial wall in pediatric patients with JSLE, with probable influence of renal pathology. RRI can be considered in the prognosis of Lupus Nephritis in pediatrics patients with JSLE

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