Clinical and Histopathologic Patterns of Lupus Nephritis in a Hispanic Cohort: A Retrospective Study

Background: Lupus Nephritis (LN) disproportionately affects hispanic populations compared to other groups. LN is found to be more severe in Hispanic patients leading to advanced renal disease. Despite these observations, this population remains underrepresented in LN literature. This study aims to enhance understanding of the clinical and histopathological features of LN and assess treatment responses within a Hispanic cohort. Methods: Using data from a single nephrology practice in Laredo, TX, we identified Hispanic patients who underwent renal biopsies from April 2014 to May 2025. Of the 315 biopsies, 19 were identified as biopsy-proven LN. A retrospective analysis was done to collect data including demographics, laboratory studies, histopathological classifications, treatments, and outcomes. Results: The median age was 30 years with 84% of patients being female. The average serum creatinine (Cr) was 2.2 mg/dL, average urine protein-to-creatinine ratio was 3.3 g/24hrs, and hematuria was present in 90% of patients. Serologic findings included 84% of patients having positive antinuclear antibodies with elevated double stranded DNA antibodies in 79% of patients. Hypocomplementemia was found in 79% of patients. The most common histopathological patterns included class V membranous (n = 12, 63%), class IV diffuse (n = 7, 37%), and class III focal (n = 5, 26%). Several biopsies (n = 9, 47%) showed overlapping class IV/V features. All patients received corticosteroids and immunosuppressant therapy: mycophenolate mofetil (n = 13, 68.4%) or cyclophosphamide (n = 6, 31.6%). Adjunctive therapy with hydroxychloroquine was used in 53% of patients. Conclusion: This study highlights the severity of LN in a Hispanic cohort, marked by a high prevalence of advanced histologic classes, consistent with previous findings of more aggressive disease in this population. By contributing to the literature on LN in Hispanic patients, we emphasize the need for more inclusive research and tailored treatment approaches.