A 29-year-old woman with SLE has new edema and hypertension. Creatinine rises from 62 to 118 micromol/L, urine protein-creatinine ratio is 320

Question

A 29-year-old woman with SLE has new edema and hypertension. Creatinine rises from 62 to 118 micromol/L, urine protein-creatinine ratio is 320 mg/mmol and urine microscopy shows red cell casts. C3 and C4 are low and anti-dsDNA titre has increased. What is the most appropriate investigation?

Accepted Answer

Kidney biopsy

Answer

Renal artery Doppler as the definitive test

Answer

Serum urate level

Answer

Repeat urinalysis in 12 months

Answer

Start long-term anticoagulation without renal assessment

Lupus nephritis — RCPSC IM MCQ

A 29-year-old woman with SLE has new edema and hypertension. Creatinine rises from 62 to 118 micromol/L, urine protein-creatinine ratio is 320 mg/mmol and urine microscopy shows red cell casts. C3 and C4 are low and anti-dsDNA titre has increased. What is the most appropriate investigation?