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Lupus nephritis — RCPSC IM MCQ

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HardRheumatologyLupus nephritisRCPSC IM

A 24-year-old woman with SLE has new leg edema and hypertension. Urine protein-creatinine ratio is 280 mg/mmol, microscopy shows red cell casts, creatinine has risen from 62 to 101 umol/L, anti-dsDNA is high and C3 is low. What is the most appropriate investigation?

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Correct answer: C — Renal biopsy to classify lupus nephritis

Proteinuria, active sediment, rising creatinine, high anti-dsDNA and low complement suggest active lupus nephritis. Kidney biopsy guides class-specific induction therapy and prognosis.

Reference: Canadian Rheumatology Association resources; KDIGO lupus nephritis guideline