Objective The aim of this study is to evaluate the prevalence, clinical, laboratory and histological types of lupus nephritis (LN) among Saudi patients.

Methods This is a retrospective study that done at King Fahad Medical City, Riyadh, Saudi Arabia, where clinical and laboratory data collected for a period from 2011–2016. All patients fulfilled the Systemic Lupus International Collaborating Clinics classification criteria (SLICC).

Results Out of 112 patients, 103 (92.0%) females, 9 (8.0%) males, mean age 34 (33.87±10.42) years. The mean of initial proteinuria level was 0.72 gm (0.72±1.34) and the mean serum creatinine 34.00 (82.33±83.88). The most common clinical characteristics were skin rash 70% and photosensitivity 61%.

With regards to comorbidities; Hypertension was found in 31 (27.7%), Hyperlipidemia in 16 (14.3%) and Diabetes mellitus in 12 (10.7%) of SLE patients.

Laboratory investigations revealed 67.0% had a positive ANA, 60.7% positive Anti DsDNA, 27.7% positive aPL, 17.9% positive Anticardiolipin igG, 18.8% positive Anticardiolipin IgM, and B2glycoprotein IgG was positive in 8.9% of patients.

44 (39.8%) out of 112 patients had a kidney biopsy and the histological types were as follow; Focal segmental glomerulosclerosis (FSGS) 2.2%, class I 2.2%, class II 6.8%, class III 27.2%, class IV 43.1%, V 6.8%, minimal change disease (MCD) 2.2%, Thrombotic Microangiopathy (TMA) 2.2%, non-specific 2.2% Normal 2.2%, poor biopsy 2.2%.

Conclusion

• The most notable clinical manifestations were skin rash 70% followed by photosensitivity 61% and arthralgia 39%.

• Patients with Hypertension, hyperlipidemia and diabetes mellitus had a higher risk of developing LN at any stage by 10%–28%.

• The commonest class of lupus nephritis among our patients as proven by kidney biopsy is class IV 43.1% followed by class III 27.2%.