The predictive role of Galectin-3 and renal arterial resistive index in patients with lupus nephritis versus other glomerulopathies

The predictive role of Galectin-3 and renal arterial resistive index in patients with lupus nephritis versus other glomerulopathies | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The predictive role of Galectin-3 and renal arterial resistive index in patients with lupus nephritis versus other glomerulopathies Rabab Elrefaey, Adel I Abdelsalam, Moheb Yara, Ahmed Mohammed Abd Elwahab, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7374078/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Galectin-3 demonstrates multifunctionality with diverse biological roles. Its potential as a biomarker for inflammation and renal fibrosis has gathered attention. The renal doppler is commonly used as a guide for intrarenal arterial resistance and has a role in the differential diagnosis of various nephropathies. Their role in predicting and diagnosing lupus nephritis (LN) groups needs to be investigated. Method This is a cross-sectional study which included 90 patients and assigned into: group 1 (patients with SLE without nephritis (NN), group 2 (patients with nephritis other than SLE (GN) and group 3 (patients with LN). Serum Galectin-3 and renal doppler ultrasound were applied and correlated with other laboratory and histopathology data. Results Galectin-3 was significantly higher in LN group than GN group. Galectin-3 has no significant correlation with interlobar artery RI. in patients with LN, Galectin-3 has positive correlation with both of total percent of glomerulosclerosis and hyaline percent but no significant correlation with activity or chronicity indices. Also, total percent of glomerulosclerosis correlated positively with main artery. The chronicity index positively correlated with the main artery RI. On the other hand, no significant correlation was observed between main artery RI and activity index. Regarding patients with GN, total percent of glomerulosclerosis positively correlated with main artery RI. Interstitial fibrosis positively correlated with main artery RI. Galectin-3 has no statistically significant correlation interstitial fibrosis or tubular atrophy in GN group. Conclusion Galectin-3 was higher in LN patients than other causes of GN. However, its role as an inflammatory marker is not confirmed by our study in correlation with lupus biomarkers or histopathological activity. Results of renal artery doppler agreed with the previous studies. Main renal artery RI was significantly correlate with the percent of glomerulosclerosis and interstitial fibrosis in both LN and GN groups. Lupus nephritis glomerulonephritis Galectin-3 renal histopathology renal artery doppler Introduction Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with multisystem involvement. Over the last decades, SLE patients’ survival has been improving, this longer survival might have been associated with an increase in damage accrual due to both disease course and treatment hazards ( 1 ). Lupus nephritis (LN) approximately affects 40% of patients with SLE. About 5–15% of these patients progress to end stage kidney disease (ESKD) within 10 years after diagnosis ( 2 ). Risk factors for progressive kidney disease include clinical parameters (proteinuria, glomerular filtration rate, complement levels, anti-dsDNA titer, presence of antiphospholipid antibodies), histopathological indicators (including measures of activity and chronicity), and nonadherence to therapy. Proteinuria is considered the best prognostic biomarker, a cutoff of 0.7–0.8 g of urinary protein/24 hours at 1 year is predictive of a good long-term renal survival ( 3 ). The correlation between the clinical profile and the actual extent or severity of kidney involvement in lupus nephritis (LN) may be inconsistent. This is why a kidney biopsy becomes crucial. It serves as a valuable tool for confirming the diagnosis of LN, provides essential information about the activity and chronicity of the disease and thus it help guide treatment decisions and offer insights into the prognosis of LN ( 4 ). Other glomerular disorders (GDs) may mimic the clinical profile of lupus nephritis and exhibit similar prognostic indicators. Determining the precise diagnosis, evaluating the degree of disease activity and severity, and assisting in prognosis prediction are all critical ( 5 ). Kidney biopsy is typically indicated in patients with a potential diagnosis of GD who have significant proteinuria, active urine sediment, elevated serum creatinine and/or decreased glomerular filtration rate [GFR] to establish the correct diagnosis, however the invasive nature of the kidney biopsy limits its wide utility in clinical practice ( 6 ). The renal sonographic morphologic changes including the size, parenchymal echogenicity and corticomedullary differentiation of the kidney on grayscale imaging may lack specificity in the evaluation of renal parenchymal disease ( 7 ). Doppler imaging provides information on changes in renal blood flow and macroabnormalities of the kidneys. The resistive index (RI) is commonly used as an index of intrarenal arterial resistance, and its use is proposed in the differential diagnosis of several nephropathies ( 8 ). Numerous pathologic diseases, including acute rejection following a kidney transplant, renal vein thrombosis, acute tubular necrosis, hemolytic uremic syndrome, crescent and proliferative glomerulonephritis, have been linked to increases in the RI ( 8 ). Biomarkers have been widely proposed as a promising diagnostic tool in patients with SLE. However, there is no solid consensus on the clinical utility of most of the studied biomarkers. Galectins are proteins that bind carbohydrates and share comparable characteristics, such as a special affinity for the β-galactosides found in glycoconjugates. Galectin-3 plays a role in the immune response, inflammation and tissue fibrosis ( 9 ). It has been extensively reported that Galectin-3 is involved in pan-organ fibrosis (i.e. liver, skin, lung, gut, myocardium, vascular, pancreas as well as kidney fibrosis) ( 10 ). In fact, Galectin-3 strongly promotes collagen synthesis in several tissues, ranging from hepatic stellate cells to synovial fibroblasts ( 11 ). Therefore, Galectin-3 represents a potentially exciting therapeutic target against tissue fibrosis independently from its etiology. Studies in vitro and in animal models demonstrate that Galectin-3 plays a pivotal role in several autoimmune and non-immune nephropathies ( 12 ). Galectin-3 is significantly upregulated during chronic allograft injury and after unilateral ureteral obstruction ,suggesting that it is finally required for the progression to renal fibrosis during chronic inflammatory responses ( 13 ). This study aimed to investigate the value of galectin-3 and renal artery doppler ultrasound assessment in relation to the kidney biopsy findings of lupus nephritis and in comparison, with non-lupus glomerulopathy. Methods Patients: This is a cross-sectional study which included patients with SLE as well as patients with non-lupus glomerulonephritis (GN), the patients included were divided into 3 groups: group 1 (patients with SLE without nephritis (NN), group 2 (patients with nephritis other than SLE (GN) and group 3 (patients with lupus nephritis (LN). Each group included 30 patients who were recruited from the nephrology & rheumatology outpatient clinics and inpatient settings, Mansoura university hospital. The study includes patients aged from 18 to 60 years old. The 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria were used to classify patients with SLE including patients with a biopsy proven lupus nephritis. Patients with active malignancy or liver disease were excluded from the study. Also, patients who diagnosed with diabetic or hypertensive nephropathy by renal biopsy were excluded. The study protocol was approved by the Institutional Research Board of the Faculty of Medicine, Mansoura University (approval registration number: MD.22.09.692.R1.R2). The study was explained to all patients, and informed written consent was obtained from all of them before starting the study. All patients were subjected to complete history taking, thorough clinical examination and laboratory investigations including serum albumin, creatinine, ESR, ANA and Anti ds DNA. Urine analysis and 24-hour urinary protein quantification were performed. Kidney biopsy was performed for all patients with evidence of nephritis or for those fulfilling LN ACR criteria. The International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification was used to stratify the histopathological abnormalities. ( 14 ). Galectin-3 measurement: Prior to kidney biopsy, venipunctures were used to take five milliliters of venous blood from each participant in an aseptic setting. Samples were gathered and placed in a tube for serum separator. Following clot formation, samples were centrifuged at 2000 g for 10 min. The sera were then separated and kept at -20˚c until analysis. As a test principle, sandwich enzyme immunoassay was employed. An antibody specific to human GAL3 has been pre-coated on the microtiter plate included in this kit. The relevant microtiter plate wells were filled with standards or samples, and a biotin-conjugated antibody that was specific to Human GAL3 was then added. Each microplate well was then filled with Avidin conjugated to Horseradish Peroxidase (HRP), and the mixture was incubated. Only the wells containing Human GAL3, biotin-conjugated antibody, and enzyme-conjugated Avidin changed color when the TMB substrate solution was introduced. Sulfuric acid solution was added to stop the enzyme-substrate reaction, and the color change was determined spectrophotometrically at 450 nm ± 10 nm. The OD of the samples was then compared to the standard curve to calculate the concentration C of Human GAL3 in the samples. Renal doppler sonography: Kidney Doppler ultrasound was performed using LOGIQ F6 device, GE Healthcare, Waukesha, WI 53188, USA, the day before Kidney biopsy, by a single expert investigator, blinded to the patients’ clinical data. Renal Doppler evaluation of the interlobar arteries along the medullary pyramids was performed by placing the probe over the region of the renal hilum and gently angulating the probe upwards and downwards to bring the upper and lower renal poles in profile. The gain was set so that background echoes were barely visible. An oblique, lateral technique was utilized for the intermediate tract and intrarenal vessels, and an anterior approach was utilized to identify the renal artery origin. The mean kidney length, end-diastolic flow velocity, peak systolic flow velocity, and RI were among the measures examined. As (peak systolic velocity–end diastolic velocity)/peak systolic velocity, the RI was computed. For the main and interlobar arteries in both kidneys, the average of the measurements made for each doppler parameter was determined. Statistical analysis: Statistical Package for Social Science (SPSS) version 22 was used in analyzing the collected information after it was recorded, coded, and tabulated using Windows on a personal computer. Medians (interquartile range: IQR), means and standard deviation (SD) were used for all quantitative values, whereas numbers of cases (%) were used to describe qualitative variables. The distribution of continuous variables was examined with Kolmogorov-Smirnov test for normality. The significance of differences between continuous variables was determined using the independent sample t test for normally distributed variables and Mann-Whitney test for not normally distributed variables, as appropriate. χ2 or Fisher exact test were used for comparison between qualitative variables, as appropriate. Univariate correlation analysis, using Pearson test for variables with normal distribution and Spearman test for non-normally distributed variables, were performed to define significant factors associated with main artery (RI and PSV) and interlobar artery (RI and PSV). Multiple linear regression analyses were done to recognize predictors of main artery RI and interlobar artery RI using enter approach. All the potential factors that can affect the three variables were included in the model. R-squared test was done to assess the variance explained by the model. The goodness of fit for the model was tested using χ2 goodness of fit tests. P value less than 0.05 was considered statistically significant. Results Patients with GN had higher serum creatinine in comparison to the NN groups. 24-hour urinary protein was significantly higher in GN group 2 than the two other groups. Galectin 3 was higher in patients with LN than patients with GN. Although it was higher in patients with NN than patients with GN, but this was not statistically significant. Comparing the renal duplex ultrasound between the 3 groups does not show a significant statistical difference ( Table 1 ). The majority of patients in the GN group had focal segmental glomerulosclerosis (FSGS) (46.7%), only one case had IgM nephropathy, 2 cases had mesangial proliferative GN. Other reported histopathological abnormalities showed 4 cases of membranoproliferative glomerulonephritis (MPGN), 4 cases of minimal change disease and 5 cases of membranous nephropathy. According to the International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification, 50% of LN cases were class 4, two cases diagnosed as class 4 + 5 LN. Class 5 LN represented 16.7%, and class 3 represented 16.7% of the LN cases (Table 2) . Serum creatinine showed a significant positive correlation with the main artery RI (r = 0.224, p = 0.034), however, did not show a statistical significance with other renal doppler parameters (Table 3) . On the other hand, Galectin-3 showed no significant correlation with the interlobar artery RI (r = 0.199, p = 0.061). Proteinuria level does not reach statistical significance with any renal doppler parameter. Table 4 shows that in patients with LN, the total percent of glomerulosclerosis correlate positively with both main artery and interlobar artery RI (r = 0.613, 0.375, p = < 0.001, 0.041 respectively). Tubular atrophy and interstitial fibrosis percent showed a significant positive correlation with the main artery RI (r = 0.511, 0.571, p = 0.004, 0.001 respectively) and the interlobar artery RI (r = 0.0415,0.395, p = 0.023, 0.031 respectively). Also, interstitial inflammatory infiltrate positively correlated with the main artery RI (r = 0.362, p = 0.049) while there was no significant correlation with other doppler parameters. However, no significant correlation was observed between main artery RI and activity index (r = 0.192, p = 0.311). On the other hand, the chronicity index positively correlated with the main artery RI (r = 0.647, p = < 0.001) and with the interlobar RI (r = 0.374, p = 0.041). Other histopathological data did not show any significant correlation with renal doppler parameters. Regarding patients with GN, the total percent of glomerulosclerosis positively correlated with the main artery RI (r = 0.415, p = 0.022) and negatively correlated with the main artery PSV (r=-0.473, p = 0.008). Moreover, tubular atrophy had negative correlation with the main artery PSV (r=-0.542, p = 0.002). Interstitial fibrosis positively correlated with the main artery RI (r = 0.417, p = 0.022) but had negative correlation with main artery PSV (r=-0.407, p = 0.026). The interlobar artery RI or PSV showed no significant correlation with the histopathologic parameters of GN group (Table 5) . Table 6 showed that Galectin-3 has no statistically significant correlation with interstitial fibrosis (r = 0.083, p = 0.665) or tubular atrophy (r=-0.004, p = 0.982) in the GN group. On the other hand, in patients with LN, Galectin-3 showed a positive correlation with both total percent of glomerulosclerosis (r = 0.388, p = 0.034) and hyaline percent (r = 0.364, p = 0.048) but no significant correlation with the activity or chronicity indices (Table 7) . While galectin-3 did not show a significant correlation with lupus biomarkers (Table 8) . Multiple linear regression analysis was done to predict the main artery RI entering a set of age, serum creatinine and percent of interstitial fibrosis as possible predictors and reveals that main artery RI increases by 0.025 for every increase in serum creatinine by 1mg/dl (Table 9) . Similarly, a multiple linear regression analysis is carried out for prediction of interlobar artery RI using a set of possible predictors including the age, serum creatinine and interstitial fibrosis. The interlobar artery RI increases by 0.014 for every 1mg/dl increase in serum creatinine (Table 10) . Discussion Glomerulonephritis (GN) is considered rare diseases, yet they are the leading cause of end-stage renal disease in young adults. Apart from diagnosing the specific type through a kidney biopsy, another crucial step in the evaluation is assessing the prognosis. This evaluation helps determine whether supportive care, with minimal side effects, is adequate or if additional immunosuppressive therapy is necessary ( 15 ). Lupus nephritis is a prevalent and common complication seen in patients with systemic lupus erythematosus, also serving as a significant contributor to renal failure and patient mortality ( 16 ). Additionally, the rates of kidney failure continue to remain alarmingly high. Moving forward, enhancing outcomes in lupus nephritis (LN) will necessitate a comprehensive strategy for LN management. This includes the discovery of novel disease markers to enable earlier detection, and patients’ stratification while identifying various effective and targeted therapies to enhance long-term LN outcomes ( 17 ). Galectin-3, belonging to the β-galactoside-binding lectin family, demonstrates multifunctionality with diverse biological roles. Its potential as a biomarker for inflammation and renal fibrosis has gathered attention ( 18 ). Galectin − 3 may be considered as an autoantigen in patients with SLE and be involved in the disease inflammatory process ( 19 ). However, this potential biomarker has not been previously studied in LN versus other GN to the best of our knowledge. In this study, Galectin-3 was significantly elevated in patients with LN than patients with GN. Moreover, Galectin-3 was elevated in patients with LN than those patients with non nephritis (NN) but did not reach a statistical significance. This come in accordance with another study by Kang et.al., that serum Galectin was elevated in SLE patients with nephritis than those without nephritis. The same study demonstrated that serum levels of Gal-3 were significantly higher in patients with SLE, particularly in those with nephritis, than in controls. Furthermore, the same study showed that serum Galectin was well correlated with anti-ds DNA in SLE patients ( 19 ). On the other hand, another study showed that Galectin-3 was not significantly different between SLE patients and control groups. Also, Galectin level was similar in SLE patients with and without nephritis ( 20 ). The current study did not find any significant correlation between serum galectin and lupus biomarkers (ANA and anti-ds DNA) which came in agreement with the study by Zhao et al ( 20 ). Of note, serum Galectin level had significant positive correlation with the total percent of glomerulosclerosis and hyalinosis in patients with LN included in this study. However, it did not show any significant correlation with the chronicity or activity indices in the same group. A study by Kang et.al., revealed a good correlation between serum Galectin-3 and the activity index but did not identify a significant correlation with the chronicity index ( 19 ). Another study used urinary galectin-3 binding protein (uG3P) as a marker of inflammation in lupus nephritis showed that uG3P positively correlated with the activity but not with chronicity index of LN ( 21 ). The role of galectin-3 in prediction of renal fibrosis needs to be further investigated. The present study did not show a significant correlation between galectin-3 and interstitial fibrosis or tubular atrophy in both GN and LN groups. Only it showed a significant positive correlation with glomerulosclerosis in LN group. However, another study by Ou et.al., that tried to study the relation of Galectin-3 and renal fibrosis in chronic kidney disease (CKD) patients, have found that plasma Galectin-3 was significantly associated with interstitial fibrosis and tubular atrophy, as well as glomerulosclerosis ( 22 ). Renal Doppler ultrasound is a non-invasive method that provides vascular information about the kidneys by measuring intra-renal blood flow parameters. Among these parameters, the renal resistive index (RRI) appears to be the most useful ( 23 ). The current work had shed light on the correlation of renal doppler data and found that only the main artery RI has positive correlation with serum creatinine but not with the degree of proteinuria or age. This relation was confirmed by multivariate regression analysis that concluded that only serum creatinine predicted the main artery RI. Although the main artery PSV did not show significant correlation with creatinine, it showed a negative correlation with age. Conversely, neither the interlobar artery RI nor PSV had significant correlation with the age or serum creatinine. Also, no significant correlation was observed between the renal doppler parameters and lupus biomarkers. The existing literature is conflicting in this context. The study by chen et. al., showed that serum creatinine positively correlated with renal artery RI and not with renal artery PSV, however it does not study the correlation of age with renal doppler parameter ( 24 ). A previous study reported a positive correlation regarding the main and interlobar artery RI with the age and eGFR, while this was not the case in another study showing a negative correlation between both the main and interlobar artery PSV and both age and eGFR ( 23 ). Renal fibrosis particularly tubulointerstitial fibrosis is the prevalent result in nearly every instance of progressive or advanced CKD, serving as a dependable indicator of prognosis and a significant contributor to renal insufficiency ( 25 ). Many studies have reported a strong correlation between kidney interstitial fibrosis and the renal resistive index ( 26 – 28 ). Similarly, our study demonstrated significant positive correlation between the main artery RI and percent of interstitial fibrosis in both LN and other GN groups. Moreover, the main artery PSV was found to have negative correlation with the degree of interstitial fibrosis and tubular atrophy in the GN but not the LN group. Nevertheless, the interlobar artery RI in the LN group showed a significant positive correlation with both interstitial fibrosis and tubular atrophy and no correlation was observed between either the main artery or interlobar artery PSV and the extent of interstitial fibrosis and tubular atrophy. In the current study, the total percent of glomerulosclerosis was significantly correlated with the main renal and interlobar artery RI of the LN group but with the main artery RI and PSV in the GN group. This came in agreement with the study of Chen et al. which showed a significant correlation between the main artery RI and glomerulosclerosis score ( 24 ). However, the existing evidence is also controversial, ( 26 ). This might be explained by the varying extent of glomerulosclerosis and interstitial fibrosis across different studies. Conclusion The present work tried to shed light on the importance of Galectin-3 as a potential marker of inflammation and fibrosis and differentiating between LN and other GN patients. Galectin-3 was higher in LN patients than other causes of GN. However, its role as inflammatory marker in not confirmed by our study in correlation with lupus biomarker or histopathological activity. Results of renal artery doppler came in accordance with the previous studies. Main renal artery RI was significantly correlate with the percent of glomerulosclerosis and interstitial fibrosis in both LN and GN groups. No significant relation was detected between galectin-3 and renal artery doppler parameters. Study limitations. We admit two important limitations of our study: first, a larger sample size would be more informative in terms of sub-analysis, second, we performed a single assessment of Galectin-3 at one study point. Despite these limitations our study still presents an important role of the renal doppler assessments in prediction of renal fibrosis. Abbreviations LN Lupus nephritis NN Non nephritis GN Glomerulonephritis SLE Systemic lupus erythematosus ESKD End stage kidney disease GDs Glomerular disorders GFR Glomerular filtration rate RI Resistive index SLICC Systemic Lupus International Collaborating Clinics ISN/RPS International Society of Nephrology/Renal Pathology Society GAL-3 Galectin 3 HRP Horseradish Peroxidase SPSS Statistical Package for Social Science SD Standard deviation IQR Interquartile range PSV Peak systolic velocity EDV End diastolic velocity FSGS focal segmental glomerulosclerosis MPGN Membranoproliferative glomerulonephritis uG3P Urinary galectin-3 binding protein CKD Chronic kidney disease Declarations Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Conflict of interest : On behalf of all authors, the corresponding author states that there is no conflict of interest. Acknowledgements: We acknowledge all our colleagues at Mansoura Nephrology and Dialysis Unit, and Rheumatology& Immunology Unit who helped us in data and sample collection. Ethical procedure: The research meets all applicable standards regarding the ethics of experimentation and research integrity, and the following is being certified/declared true. As an expert scientist and along with co-authors of concerned field, the paper has been submitted with full responsibility, following due ethical procedure, and there is no duplicate publication, fraud, plagiarism, or concerns about animal or human experimentation. The study adhered to the Declaration of Helsinki, approved by the ethics committee at our university and approved by the Institutional Research Board of the Faculty of Medicine, Mansoura University (approval registration number: MD.22.09.692.R1.R2). Consent to participate: The study was explained to all individual participants included in the study, and informed consent was obtained from all of them before starting the study. Authors' contributions: Conceptualization& Methodology : RE, MSA & AMA; Formal analysis and investigation : MY, KN &MN; Writing - original draft : RE; Writing - review and editing : KN& RS; Supervision : AA. References Insfrán CE, Aikawa NE, Pasoto SG, Filho DM, Formiga FF, Pitta AC et al. 2019-EULAR/ACR classification criteria domains at diagnosis: predictive factors of long-term damage in systemic lupus erythematosus. Clin Rheumatol. 2022:1–7. Avasare R, Drexler Y, Caster DJ, Mitrofanova A, Jefferson JA. Management of Lupus Nephritis: New Treatments and Updated Guidelines. Kidney360. 2023;4(10):1503–11. Mackay M, Dall'Era M, Fishbein J, Kalunian K, Lesser M, Sanchez-Guerrero J, et al. 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Radermacher J, Mengel M, Ellis S, Stuht S, Hiss M, Schwarz A, et al. The renal arterial resistance index and renal allograft survival. N Engl J Med. 2003;349(2):115–24. Tables Table (1) Comparison of demographic, laboratory and duplex sonography results between NN, GN and LN groups: Variable Group 1(NN) Group 2(GN) Group 3(LN) P Age (years) 31.50 (25.75-39.25) 34.5(26-53) 28.5(21.5-35) 0.060 Sex Male n (%) Female n (%) 0(0) 30(100) 18(60) 12(40) 3(10) 27(90) <0.001 SLE duration (years) Median (IQR) 4.5(0.87-6) 0(0-0) 1.5(0.5-5) 0.134 Creatinine (mg/dl) Median (IQR) 0.9(0.67-1) 1 1.2(0.9-2.65) 1,2 0.8(0.6-1.55) 2 0.001 serum albumin (g/dl) Median (IQR) 4(3.5-4) 1,2 2.35(1.8-3.5) 1 3(2.475-3.1) 2 <0.001 ANA (IU/ml) Median (IQR) 23(18.2-40) 1 0(0-0) 95(60-192) 1 <0.001 anti dsDNA (IU/ml) Median (IQR) 11(10-20) 1 0(0-0) 75(30-147) 1 <0.001 ESR (mm/hr) Median (IQR) 40(30-80) 1,2 85(58.75-111.25) 2 83.5(51.2-100) 1 0.002 Galectin-3 (ng/ml) Median (IQR) 0.41(0.25-0.76) 0.27(0.15-0.57) 1 0.56(0.25-0.96) 1 0.022 24-hour urinary protein (g/ day) Median (IQR) 0.17(0.1-0.22) 1,2 5.5(4.3-7.25) 2,3 2.95(2-3.2) 1,3 <0.001 Kidney length (cm) Median (IQR) 10.65(10.34-11.025) 1 11.45(10.68-11.93) 11.47(10.95-12.01) 1 0.010 Kidney transverse diameter (cm) Median (IQR) 4.65(4.34-5) 1 5(4.75-5.25) 1 4.825(4.63-5.01) 0.034 Main art RI Median (IQR) 0.56 (0.527-0.62) 0.58(0.53-0.61) 0.58 (0.53-0.66) 0.875 Main art PSV (cm/s) Median (IQR) 41.93±7.98 37.88±9.5 43.69±12.62 0.084 Main art EDV (cm/s) Median (IQR) 16.9 (14.77-20.38) 15.95(11.18-19.11) 16.63 (13.4-20.61) 0.875 Interlobar RI Median (IQR) 0.56(0.53-0.60) 0.56(0.53-0.58) 0.59(0.53-0.62) 0.113 Interlobar PSV (cm/s) Median (IQR) 34.4±5.93 32.67±7.7 34.92±8.38 0.474 Interlobar EDV (cm/s) Median (IQR) 16.9(14.775-20.38) 13.95±4.11 16.62(13.4-20.61) 0.593 Table (2) pattern of GN and classes of lupus nephritis across the studied groups: GN types LN classes Membranous n (%) 5 ) 16.7 ( Class 1 n (%) 1 ) 3.3 ( FSGS n (%) 14 ) 46.7 ( Class 2 n (%) 2 ) 6.7 ( minimal change n (%) 4 ) 13.3 ( Class 3 n (%) 5 ) 16.7 ( IgM nephropathy n (%) 1 ) 3.3 ( Class 4 n (%) 15 ) 50.0 ( MPGN n (%) 4 ) 13.3 ( Class 5 n (%) 5 ) 16.7 ( mesangial proliferative n (%) 2 ) 6.7 ( Class 4+5 n (%) 2 ) 6.7 ( Table (3) Correlation between renal duplex and different variables across all the 3 groups: Variable Main artery RI Main artery PSV Interlobar artery RI Interlobar artery PSV R P R P R P R P Age (years) 0.191 0.072 -0.211 0.046 0.152 0.152 -0.185 0.081 Creatinine (mg/dl) 0.224 0.034 -0.204 0.053 0.062 0.560 -0.187 0.078 serum albumin (g/dl) 0.027 0.798 -0.065 0.543 -0.067 0.532 -0.138 0.196 ANA (IU/ml) 0.083 0.438 0.039 0.713 0.130 0.222 0.015 0.887 anti dsDNA (IU/ml) 0.032 0.762 0.166 0.118 0.042 0.691 0.105 0.323 24-hour urinary protein (g/day) -0.021 0.842 -0.073 0.496 -0.021 0.844 -0.064 0.546 Galectin-3 (ng/ml) 0.138 0.194 -0.042 0.692 0.199 0.061 0.057 0.592 ESR (mm/hr) 0.018 0.868 -0.104 0.331 -0.015 0.890 -0.086 0.419 Table (4) Correlation between renal duplex and renal histopathology of LN group: Variable Main RI Main art PSV Interlobar RI Interlobar artery PSV R P R P R P R P total percent of glomerulosclerosis 0.613 <0.001 0.112 0.557 0.375 0.041 -0.310 0.096 Hypercellularity percent -0.003 0.986 0.202 0.285 -0.166 0.381 -0.058 0.759 cellular crescent percent 0.098 0.606 0.318 0.087 -0.117 0.538 -0.212 0.262 fibrous crescent percent 0.236 0.209 0.124 0.515 -0.169 0.372 -0.208 0.271 hyaline percent 0.264 0.158 0.085 0.655 0.317 0.088 0.190 0.316 fibrinoid necrosis percent 0.129 0.495 0.234 0.213 -0.114 0.550 0.028 0.882 neutrophil karyorrhexis percent 0.091 0.632 0.247 0.189 -0.152 0.424 0.078 0.683 Tubular atrophy percent 0.511 0.004 0.130 0.493 0.0415 0.023 -0.163 0.389 interstitial fibrosis percent 0.571 0.001 0.115 0.546 0.395 0.031 -0.152 0.423 interstitial inflammatory infiltrate percent 0.362 0.049 0.267 0.153 0.159 0.159 -0.118 0.535 Activity index 0.192 0.311 0.237 0.207 -0.013 0.945 -0.064 0.737 Chronicity index 0.647 <0.001 0.193 0.307 0.374 0.041 -0.232 0.218 Table (5) Correlation between renal duplex and renal histopathology of GN groups: Variable Main artery RI Main artery PSV Interlobar artery RI Interlobar artery PSV R P R P R P R P Total percent of glomerulosclerosis 0.415 0.022 -0.473 0.008 0.322 0.083 -0.291 0.119 Hypercellularity percent -0.223 0.235 -0.233 0.215 0.014 0.943 -0.028 0.884 Cellular crescent percent -0.041 0.829 -0.305 0.102 0.251 0.181 0.279 0.135 Fibrous crescent percent 0.137 0.469 -0.261 0.164 0.217 0.250 0.210 0.264 Tubular atrophy percent 0.298 0.109 -0.542 0.002 0.236 0.209 -0.298 0.110 Interstitial fibrosis percent 0.417 0.022 -0.407 0.026 0.296 0.112 -0.216 0.251 Interstitial inflammatory infiltrate percent 0.128 0.501 -0.220 0.242 -0.171 0.365 -0.156 0.410 Table (6) correlation of galectin-3 with histopathology of GN group: Variable R P total percent of glomerulosclerosis 0.155 0.413 Hypercellularity percent 0.227 0.228 Tubular atrophy percent -0.004 0.982 interstitial fibrosis percent 0.083 0.665 interstitial inflammatory infiltrate percent 0.276 0.140 Table (7) Correlation of galectin 3 with histopathology of LN group: Variable R P total percent of glomerulosclerosis 0.388 0.034 Hypercellularity percent -0.094 0.623 cellular crescent percent -0.083 0.662 fibrous crescent percent -0.064 0.737 hyaline percent 0.364 0.048 fibrinoid necrosis percent -0.134 0.481 neutrophil karyorrhexis percent -0.068 0.721 Tubular atrophy percent 0.180 0.341 interstitial fibrosis percent 0.302 0.104 interstitial inflammatory infiltrate percent 0.173 0.361 Activity index 0.122 0.521 Chronicity index 0.309 0.097 Table (8) correlation of Galectin-3 with lupus biomarkers: Variable R P ANA -0.063 0.631 Anti ds DNA 0.039 0.768 Table (9) Multivariate regression analysis of main artery RI: Variable B Beta 95.0% CI P (Constant) 0.546 (0.491-0.602) <0.001 Age(years) -0.001 -0.112 (-0.003-0.001) 0.343 Creatinine (mg/dl) 0.025 0.494 (0.010-0.039) 0.001 interstitial fibrosis percent 0.001 0.257 (0.000-0.002) 0.069 Table (10) Multivariate regression analysis of interlobar artery RI: Variable B Beta 95.0% CI p (Constant) 0.537 (0.493-0.582) <0.001 Age (years) 0.000 0.055 (-0.001-0.002) 0.683 Creatinine (mg/dl) 0.014 0.393 (0.002-0.025) 0.022 interstitial fibrosis percent 0.000 0.084 (-0.001-0.001) 0.597 Additional Declarations No competing interests reported. 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Nahas","email":"","orcid":"","institution":"Mansoura University","correspondingAuthor":false,"prefix":"","firstName":"Mohamed","middleName":"M.","lastName":"Nahas","suffix":""},{"id":514974765,"identity":"737e5495-db5c-4a56-a239-9b75a7cbe29e","order_by":7,"name":"Kareem N. Zayed","email":"","orcid":"","institution":"Mansoura University","correspondingAuthor":false,"prefix":"","firstName":"Kareem","middleName":"N.","lastName":"Zayed","suffix":""}],"badges":[],"createdAt":"2025-08-14 12:53:37","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7374078/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7374078/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":93207339,"identity":"07710a2b-2983-4578-b6b0-22dffe1bf4eb","added_by":"auto","created_at":"2025-10-10 08:17:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1480777,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7374078/v1/c1055f52-b6a0-42d3-927d-ff5ffb0d0079.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The predictive role of Galectin-3 and renal arterial resistive index in patients with lupus nephritis versus other glomerulopathies","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSystemic lupus erythematosus (SLE) is a systemic autoimmune disease with multisystem involvement. Over the last decades, SLE patients\u0026rsquo; survival has been improving, this longer survival might have been associated with an increase in damage accrual due to both disease course and treatment hazards (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eLupus nephritis (LN) approximately affects 40% of patients with SLE. About 5\u0026ndash;15% of these patients progress to end stage kidney disease (ESKD) within 10 years after diagnosis (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Risk factors for progressive kidney disease include clinical parameters (proteinuria, glomerular filtration rate, complement levels, anti-dsDNA titer, presence of antiphospholipid antibodies), histopathological indicators (including measures of activity and chronicity), and nonadherence to therapy. Proteinuria is considered the best prognostic biomarker, a cutoff of 0.7\u0026ndash;0.8 g of urinary protein/24 hours at 1 year is predictive of a good long-term renal survival (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe correlation between the clinical profile and the actual extent or severity of kidney involvement in lupus nephritis (LN) may be inconsistent. This is why a kidney biopsy becomes crucial. It serves as a valuable tool for confirming the diagnosis of LN, provides essential information about the activity and chronicity of the disease and thus it help guide treatment decisions and offer insights into the prognosis of LN (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eOther glomerular disorders (GDs) may mimic the clinical profile of lupus nephritis and exhibit similar prognostic indicators. Determining the precise diagnosis, evaluating the degree of disease activity and severity, and assisting in prognosis prediction are all critical (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eKidney biopsy is typically indicated in patients with a potential diagnosis of GD who have significant proteinuria, active urine sediment, elevated serum creatinine and/or decreased glomerular filtration rate [GFR] to establish the correct diagnosis, however the invasive nature of the kidney biopsy limits its wide utility in clinical practice (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe renal sonographic morphologic changes including the size, parenchymal echogenicity and corticomedullary differentiation of the kidney on grayscale imaging may lack specificity in the evaluation of renal parenchymal disease (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Doppler imaging provides information on changes in renal blood flow and macroabnormalities of the kidneys. The resistive index (RI) is commonly used as an index of intrarenal arterial resistance, and its use is proposed in the differential diagnosis of several nephropathies (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Numerous pathologic diseases, including acute rejection following a kidney transplant, renal vein thrombosis, acute tubular necrosis, hemolytic uremic syndrome, crescent and proliferative glomerulonephritis, have been linked to increases in the RI (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eBiomarkers have been widely proposed as a promising diagnostic tool in patients with SLE. However, there is no solid consensus on the clinical utility of most of the studied biomarkers. Galectins are proteins that bind carbohydrates and share comparable characteristics, such as a special affinity for the β-galactosides found in glycoconjugates. Galectin-3 plays a role in the immune response, inflammation and tissue fibrosis (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). It has been extensively reported that Galectin-3 is involved in pan-organ fibrosis (i.e. liver, skin, lung, gut, myocardium, vascular, pancreas as well as kidney fibrosis) (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). In fact, Galectin-3 strongly promotes collagen synthesis in several tissues, ranging from hepatic stellate cells to synovial fibroblasts (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Therefore, Galectin-3 represents a potentially exciting therapeutic target against tissue fibrosis independently from its etiology. Studies in vitro and in animal models demonstrate that Galectin-3 plays a pivotal role in several autoimmune and non-immune nephropathies (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Galectin-3 is significantly upregulated during chronic allograft injury and after unilateral ureteral obstruction ,suggesting that it is finally required for the progression to renal fibrosis during chronic inflammatory responses (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). This study aimed to investigate the value of galectin-3 and renal artery doppler ultrasound assessment in relation to the kidney biopsy findings of lupus nephritis and in comparison, with non-lupus glomerulopathy.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003ePatients:\u003c/h2\u003e\u003cp\u003eThis is a cross-sectional study which included patients with SLE as well as patients with non-lupus glomerulonephritis (GN), the patients included were divided into 3 groups: group 1 (patients with SLE without nephritis (NN), group 2 (patients with nephritis other than SLE (GN) and group 3 (patients with lupus nephritis (LN). Each group included 30 patients who were recruited from the nephrology \u0026amp; rheumatology outpatient clinics and inpatient settings, Mansoura university hospital. The study includes patients aged from 18 to 60 years old. The 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria were used to classify patients with SLE including patients with a biopsy proven lupus nephritis. Patients with active malignancy or liver disease were excluded from the study. Also, patients who diagnosed with diabetic or hypertensive nephropathy by renal biopsy were excluded. The study protocol was approved by the Institutional Research Board of the Faculty of Medicine, Mansoura University (approval registration number: MD.22.09.692.R1.R2). The study was explained to all patients, and informed written consent was obtained from all of them before starting the study.\u003c/p\u003e\u003cp\u003eAll patients were subjected to complete history taking, thorough clinical examination and laboratory investigations including serum albumin, creatinine, ESR, ANA and Anti ds DNA. Urine analysis and 24-hour urinary protein quantification were performed. Kidney biopsy was performed for all patients with evidence of nephritis or for those fulfilling LN ACR criteria. The International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification was used to stratify the histopathological abnormalities. (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eGalectin-3 measurement:\u003c/h3\u003e\n\u003cp\u003ePrior to kidney biopsy, venipunctures were used to take five milliliters of venous blood from each participant in an aseptic setting. Samples were gathered and placed in a tube for serum separator. Following clot formation, samples were centrifuged at 2000 g for 10 min. The sera were then separated and kept at -20˚c until analysis. As a test principle, sandwich enzyme immunoassay was employed. An antibody specific to human GAL3 has been pre-coated on the microtiter plate included in this kit. The relevant microtiter plate wells were filled with standards or samples, and a biotin-conjugated antibody that was specific to Human GAL3 was then added. Each microplate well was then filled with Avidin conjugated to Horseradish Peroxidase (HRP), and the mixture was incubated. Only the wells containing Human GAL3, biotin-conjugated antibody, and enzyme-conjugated Avidin changed color when the TMB substrate solution was introduced. Sulfuric acid solution was added to stop the enzyme-substrate reaction, and the color change was determined spectrophotometrically at 450 nm\u0026thinsp;\u0026plusmn;\u0026thinsp;10 nm. The OD of the samples was then compared to the standard curve to calculate the concentration C of Human GAL3 in the samples.\u003c/p\u003e\n\u003ch3\u003eRenal doppler sonography:\u003c/h3\u003e\n\u003cp\u003eKidney Doppler ultrasound was performed using LOGIQ F6 device, GE Healthcare, Waukesha, WI 53188, USA, the day before Kidney biopsy, by a single expert investigator, blinded to the patients\u0026rsquo; clinical data. Renal Doppler evaluation of the interlobar arteries along the medullary pyramids was performed by placing the probe over the region of the renal hilum and gently angulating the probe upwards and downwards to bring the upper and lower renal poles in profile. The gain was set so that background echoes were barely visible. An oblique, lateral technique was utilized for the intermediate tract and intrarenal vessels, and an anterior approach was utilized to identify the renal artery origin. The mean kidney length, end-diastolic flow velocity, peak systolic flow velocity, and RI were among the measures examined. As (peak systolic velocity\u0026ndash;end diastolic velocity)/peak systolic velocity, the RI was computed. For the main and interlobar arteries in both kidneys, the average of the measurements made for each doppler parameter was determined.\u003c/p\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003eStatistical analysis:\u003c/h2\u003e\u003cp\u003eStatistical Package for Social Science (SPSS) version 22 was used in analyzing the collected information after it was recorded, coded, and tabulated using Windows on a personal computer. Medians (interquartile range: IQR), means and standard deviation (SD) were used for all quantitative values, whereas numbers of cases (%) were used to describe qualitative variables. The distribution of continuous variables was examined with Kolmogorov-Smirnov test for normality. The significance of differences between continuous variables was determined using the independent sample t test for normally distributed variables and Mann-Whitney test for not normally distributed variables, as appropriate. χ2 or Fisher exact test were used for comparison between qualitative variables, as appropriate. Univariate correlation analysis, using Pearson test for variables with normal distribution and Spearman test for non-normally distributed variables, were performed to define significant factors associated with main artery (RI and PSV) and interlobar artery (RI and PSV). Multiple linear regression analyses were done to recognize predictors of main artery RI and interlobar artery RI using enter approach. All the potential factors that can affect the three variables were included in the model. R-squared test was done to assess the variance explained by the model. The goodness of fit for the model was tested using χ2 goodness of fit tests. P value less than 0.05 was considered statistically significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003ePatients with GN had higher serum creatinine in comparison to the NN groups. 24-hour urinary protein was significantly higher in GN group 2 than the two other groups. Galectin 3 was higher in patients with LN than patients with GN. Although it was higher in patients with NN than patients with GN, but this was not statistically significant. Comparing the renal duplex ultrasound between the 3 groups does not show a significant statistical difference (\u003cb\u003eTable\u0026nbsp;1\u003c/b\u003e).\u003c/p\u003e\u003cp\u003eThe majority of patients in the GN group had focal segmental glomerulosclerosis (FSGS) (46.7%), only one case had IgM nephropathy, 2 cases had mesangial proliferative GN. Other reported histopathological abnormalities showed 4 cases of membranoproliferative glomerulonephritis (MPGN), 4 cases of minimal change disease and 5 cases of membranous nephropathy. According to the International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification, 50% of LN cases were class 4, two cases diagnosed as class 4\u0026thinsp;+\u0026thinsp;5 LN. Class 5 LN represented 16.7%, and class 3 represented 16.7% of the LN cases \u003cb\u003e(Table\u0026nbsp;2)\u003c/b\u003e.\u003c/p\u003e\u003cp\u003eSerum creatinine showed a significant positive correlation with the main artery RI (r\u0026thinsp;=\u0026thinsp;0.224, p\u0026thinsp;=\u0026thinsp;0.034), however, did not show a statistical significance with other renal doppler parameters \u003cb\u003e(Table\u0026nbsp;3)\u003c/b\u003e. On the other hand, Galectin-3 showed no significant correlation with the interlobar artery RI (r\u0026thinsp;=\u0026thinsp;0.199, p\u0026thinsp;=\u0026thinsp;0.061). Proteinuria level does not reach statistical significance with any renal doppler parameter.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTable\u0026nbsp;4\u003c/b\u003e shows that in patients with LN, the total percent of glomerulosclerosis correlate positively with both main artery and interlobar artery RI (r\u0026thinsp;=\u0026thinsp;0.613, 0.375, p\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001, 0.041 respectively). Tubular atrophy and interstitial fibrosis percent showed a significant positive correlation with the main artery RI (r\u0026thinsp;=\u0026thinsp;0.511, 0.571, p\u0026thinsp;=\u0026thinsp;0.004, 0.001 respectively) and the interlobar artery RI (r\u0026thinsp;=\u0026thinsp;0.0415,0.395, p\u0026thinsp;=\u0026thinsp;0.023, 0.031 respectively). Also, interstitial inflammatory infiltrate positively correlated with the main artery RI (r\u0026thinsp;=\u0026thinsp;0.362, p\u0026thinsp;=\u0026thinsp;0.049) while there was no significant correlation with other doppler parameters. However, no significant correlation was observed between main artery RI and activity index (r\u0026thinsp;=\u0026thinsp;0.192, p\u0026thinsp;=\u0026thinsp;0.311). On the other hand, the chronicity index positively correlated with the main artery RI (r\u0026thinsp;=\u0026thinsp;0.647, p\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and with the interlobar RI (r\u0026thinsp;=\u0026thinsp;0.374, p\u0026thinsp;=\u0026thinsp;0.041). Other histopathological data did not show any significant correlation with renal doppler parameters.\u003c/p\u003e\u003cp\u003eRegarding patients with GN, the total percent of glomerulosclerosis positively correlated with the main artery RI (r\u0026thinsp;=\u0026thinsp;0.415, p\u0026thinsp;=\u0026thinsp;0.022) and negatively correlated with the main artery PSV (r=-0.473, p\u0026thinsp;=\u0026thinsp;0.008). Moreover, tubular atrophy had negative correlation with the main artery PSV (r=-0.542, p\u0026thinsp;=\u0026thinsp;0.002). Interstitial fibrosis positively correlated with the main artery RI (r\u0026thinsp;=\u0026thinsp;0.417, p\u0026thinsp;=\u0026thinsp;0.022) but had negative correlation with main artery PSV (r=-0.407, p\u0026thinsp;=\u0026thinsp;0.026). The interlobar artery RI or PSV showed no significant correlation with the histopathologic parameters of GN group \u003cb\u003e(Table\u0026nbsp;5)\u003c/b\u003e.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTable\u0026nbsp;6\u003c/b\u003e showed that Galectin-3 has no statistically significant correlation with interstitial fibrosis (r\u0026thinsp;=\u0026thinsp;0.083, p\u0026thinsp;=\u0026thinsp;0.665) or tubular atrophy (r=-0.004, p\u0026thinsp;=\u0026thinsp;0.982) in the GN group. On the other hand, in patients with LN, Galectin-3 showed a positive correlation with both total percent of glomerulosclerosis (r\u0026thinsp;=\u0026thinsp;0.388, p\u0026thinsp;=\u0026thinsp;0.034) and hyaline percent (r\u0026thinsp;=\u0026thinsp;0.364, p\u0026thinsp;=\u0026thinsp;0.048) but no significant correlation with the activity or chronicity indices \u003cb\u003e(Table\u0026nbsp;7)\u003c/b\u003e. While galectin-3 did not show a significant correlation with lupus biomarkers \u003cb\u003e(Table\u0026nbsp;8)\u003c/b\u003e.\u003c/p\u003e\u003cp\u003eMultiple linear regression analysis was done to predict the main artery RI entering a set of age, serum creatinine and percent of interstitial fibrosis as possible predictors and reveals that main artery RI increases by 0.025 for every increase in serum creatinine by 1mg/dl \u003cb\u003e(Table\u0026nbsp;9)\u003c/b\u003e. Similarly, a multiple linear regression analysis is carried out for prediction of interlobar artery RI using a set of possible predictors including the age, serum creatinine and interstitial fibrosis. The interlobar artery RI increases by 0.014 for every 1mg/dl increase in serum creatinine \u003cb\u003e(Table\u0026nbsp;10)\u003c/b\u003e.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eGlomerulonephritis (GN) is considered rare diseases, yet they are the leading cause of end-stage renal disease in young adults. Apart from diagnosing the specific type through a kidney biopsy, another crucial step in the evaluation is assessing the prognosis. This evaluation helps determine whether supportive care, with minimal side effects, is adequate or if additional immunosuppressive therapy is necessary (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eLupus nephritis is a prevalent and common complication seen in patients with systemic lupus erythematosus, also serving as a significant contributor to renal failure and patient mortality (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Additionally, the rates of kidney failure continue to remain alarmingly high. Moving forward, enhancing outcomes in lupus nephritis (LN) will necessitate a comprehensive strategy for LN management. This includes the discovery of novel disease markers to enable earlier detection, and patients\u0026rsquo; stratification while identifying various effective and targeted therapies to enhance long-term LN outcomes (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eGalectin-3, belonging to the β-galactoside-binding lectin family, demonstrates multifunctionality with diverse biological roles. Its potential as a biomarker for inflammation and renal fibrosis has gathered attention (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Galectin \u0026minus;\u0026thinsp;3 may be considered as an autoantigen in patients with SLE and be involved in the disease inflammatory process (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). However, this potential biomarker has not been previously studied in LN versus other GN to the best of our knowledge. In this study, Galectin-3 was significantly elevated in patients with LN than patients with GN. Moreover, Galectin-3 was elevated in patients with LN than those patients with non nephritis (NN) but did not reach a statistical significance. This come in accordance with another study by Kang et.al., that serum Galectin was elevated in SLE patients with nephritis than those without nephritis. The same study demonstrated that serum levels of Gal-3 were significantly higher in patients with SLE, particularly in those with nephritis, than in controls. Furthermore, the same study showed that serum Galectin was well correlated with anti-ds DNA in SLE patients (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). On the other hand, another study showed that Galectin-3 was not significantly different between SLE patients and control groups. Also, Galectin level was similar in SLE patients with and without nephritis (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). The current study did not find any significant correlation between serum galectin and lupus biomarkers (ANA and anti-ds DNA) which came in agreement with the study by \u003cb\u003eZhao et al\u003c/b\u003e (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eOf note, serum Galectin level had significant positive correlation with the total percent of glomerulosclerosis and hyalinosis in patients with LN included in this study. However, it did not show any significant correlation with the chronicity or activity indices in the same group. A study by Kang et.al., revealed a good correlation between serum Galectin-3 and the activity index but did not identify a significant correlation with the chronicity index (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Another study used urinary galectin-3 binding protein (uG3P) as a marker of inflammation in lupus nephritis showed that uG3P positively correlated with the activity but not with chronicity index of LN (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe role of galectin-3 in prediction of renal fibrosis needs to be further investigated. The present study did not show a significant correlation between galectin-3 and interstitial fibrosis or tubular atrophy in both GN and LN groups. Only it showed a significant positive correlation with glomerulosclerosis in LN group. However, another study by Ou et.al., that tried to study the relation of Galectin-3 and renal fibrosis in chronic kidney disease (CKD) patients, have found that plasma Galectin-3 was significantly associated with interstitial fibrosis and tubular atrophy, as well as glomerulosclerosis (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eRenal Doppler ultrasound is a non-invasive method that provides vascular information about the kidneys by measuring intra-renal blood flow parameters. Among these parameters, the renal resistive index (RRI) appears to be the most useful (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). The current work had shed light on the correlation of renal doppler data and found that only the main artery RI has positive correlation with serum creatinine but not with the degree of proteinuria or age. This relation was confirmed by multivariate regression analysis that concluded that only serum creatinine predicted the main artery RI. Although the main artery PSV did not show significant correlation with creatinine, it showed a negative correlation with age. Conversely, neither the interlobar artery RI nor PSV had significant correlation with the age or serum creatinine. Also, no significant correlation was observed between the renal doppler parameters and lupus biomarkers. The existing literature is conflicting in this context. The study by chen et. al., showed that serum creatinine positively correlated with renal artery RI and not with renal artery PSV, however it does not study the correlation of age with renal doppler parameter (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). A previous study reported a positive correlation regarding the main and interlobar artery RI with the age and eGFR, while this was not the case in another study showing a negative correlation between both the main and interlobar artery PSV and both age and eGFR (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eRenal fibrosis particularly tubulointerstitial fibrosis is the prevalent result in nearly every instance of progressive or advanced CKD, serving as a dependable indicator of prognosis and a significant contributor to renal insufficiency (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Many studies have reported a strong correlation between kidney interstitial fibrosis and the renal resistive index (\u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Similarly, our study demonstrated significant positive correlation between the main artery RI and percent of interstitial fibrosis in both LN and other GN groups. Moreover, the main artery PSV was found to have negative correlation with the degree of interstitial fibrosis and tubular atrophy in the GN but not the LN group. Nevertheless, the interlobar artery RI in the LN group showed a significant positive correlation with both interstitial fibrosis and tubular atrophy and no correlation was observed between either the main artery or interlobar artery PSV and the extent of interstitial fibrosis and tubular atrophy.\u003c/p\u003e\u003cp\u003eIn the current study, the total percent of glomerulosclerosis was significantly correlated with the main renal and interlobar artery RI of the LN group but with the main artery RI and PSV in the GN group. This came in agreement with the study of Chen et al. which showed a significant correlation between the main artery RI and glomerulosclerosis score (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). However, the existing evidence is also controversial, (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). This might be explained by the varying extent of glomerulosclerosis and interstitial fibrosis across different studies.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe present work tried to shed light on the importance of Galectin-3 as a potential marker of inflammation and fibrosis and differentiating between LN and other GN patients. Galectin-3 was higher in LN patients than other causes of GN. However, its role as inflammatory marker in not confirmed by our study in correlation with lupus biomarker or histopathological activity. Results of renal artery doppler came in accordance with the previous studies. Main renal artery RI was significantly correlate with the percent of glomerulosclerosis and interstitial fibrosis in both LN and GN groups. No significant relation was detected between galectin-3 and renal artery doppler parameters.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy limitations.\u003c/b\u003e\u003c/p\u003e\u003cp\u003eWe admit two important limitations of our study: first, a larger sample size would be more informative in terms of sub-analysis, second, we performed a single assessment of Galectin-3 at one study point. Despite these limitations our study still presents an important role of the renal doppler assessments in prediction of renal fibrosis.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eLN\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eLupus nephritis\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eNN\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eNon nephritis\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eGN\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eGlomerulonephritis\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSLE\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eSystemic lupus erythematosus\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eESKD\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eEnd stage kidney disease\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eGDs\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eGlomerular disorders\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eGFR\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eGlomerular filtration rate\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eRI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eResistive index\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSLICC\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eSystemic Lupus International Collaborating Clinics\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eISN/RPS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eInternational Society of Nephrology/Renal Pathology Society\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eGAL-3\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eGalectin 3\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eHRP\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eHorseradish Peroxidase\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eStatistical Package for Social Science\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSD\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eStandard deviation\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eIQR\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eInterquartile range\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePSV\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ePeak systolic velocity\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eEDV\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eEnd diastolic velocity\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eFSGS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003efocal segmental glomerulosclerosis\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMPGN\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMembranoproliferative glomerulonephritis\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003euG3P\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eUrinary galectin-3 binding protein\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCKD\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eChronic kidney disease\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e: On behalf of all authors, the corresponding author states that there is no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe acknowledge all our colleagues at Mansoura Nephrology and Dialysis Unit, and Rheumatology\u0026amp; Immunology Unit who helped us in data and sample collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical procedure:\u003c/strong\u003e\u003c/p\u003e\n\u003cul class=\"decimal_type\"\u003e\n \u003cli\u003eThe research meets all applicable standards regarding the ethics of experimentation and research integrity, and the following is being certified/declared true.\u003c/li\u003e\n \u003cli\u003eAs an expert scientist and along with co-authors of concerned field, the paper has been submitted with full responsibility, following due ethical procedure, and there is no duplicate publication, fraud, plagiarism, or concerns about animal or human experimentation.\u003c/li\u003e\n \u003cli\u003eThe study adhered to the Declaration of Helsinki, approved by the ethics committee at our university\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eand approved by the Institutional Research Board of the Faculty of Medicine, Mansoura University (approval registration number: MD.22.09.692.R1.R2).\u003c/li\u003e\n \u003cli\u003eConsent to participate: The study was explained to all individual participants included in the study, and informed consent was obtained from all of them before starting the study.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConceptualization\u0026amp; Methodology\u003c/strong\u003e: RE, MSA \u0026amp; AMA; \u003cstrong\u003eFormal analysis and investigation\u003c/strong\u003e: MY, KN \u0026amp;MN; \u003cstrong\u003eWriting - original draft\u003c/strong\u003e: RE; \u003cstrong\u003eWriting\u003c/strong\u003e \u003cstrong\u003e- review and editing\u003c/strong\u003e: KN\u0026amp; RS; \u003cstrong\u003eSupervision\u003c/strong\u003e: AA.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eInsfr\u0026aacute;n CE, Aikawa NE, Pasoto SG, Filho DM, Formiga FF, Pitta AC et al. 2019-EULAR/ACR classification criteria domains at diagnosis: predictive factors of long-term damage in systemic lupus erythematosus. Clin Rheumatol. 2022:1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAvasare R, Drexler Y, Caster DJ, Mitrofanova A, Jefferson JA. Management of Lupus Nephritis: New Treatments and Updated Guidelines. Kidney360. 2023;4(10):1503\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMackay M, Dall'Era M, Fishbein J, Kalunian K, Lesser M, Sanchez-Guerrero J, et al. Establishing surrogate kidney end points for lupus nephritis clinical trials: development and validation of a novel approach to predict future kidney outcomes. Arthritis Rheumatol. 2019;71(3):411\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRovin BH, Adler SG, Barratt J, Bridoux F, Burdge KA, Chan TM, et al. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int. 2021;100(4):S1\u0026ndash;276.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlYousef A, AlSahow A, AlHelal B, Alqallaf A, Abdallah E, Abdellatif M, et al. Glomerulonephritis histopathological pattern change. BMC Nephrol. 2020;21:1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAnders H-J, Kitching AR, Leung N, Romagnani P. Glomerulonephritis: immunopathogenesis and immunotherapy. Nat Rev Immunol. 2023;23(7):453\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKrumme B. Renal Doppler sonography\u0026ndash;update in clinical nephrology. Nephron Clin Pract. 2006;103(2):c24\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRosato E, Gigante A, Barbano B, Cianci R, Molinaro I, Rossi C, et al. editors. Intrarenal hemodynamic parameters correlate with glomerular filtration rate and digital microvascular damage in patients with systemic sclerosis. Seminars in arthritis and rheumatism. Elsevier; 2012.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVasta GR. Galectins as pattern recognition receptors: structure, function, and evolution. Current topics in innate immunity II. 2012:21\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ede Oliveira FL, Gatto M, Bassi N, Luisetto R, Ghirardello A, Punzi L, et al. Galectin-3 in autoimmunity and autoimmune diseases. Experimental biology Med. 2015;240(8):1019\u0026ndash;28.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFiler A, Bik M, Parsonage GN, Fitton J, Trebilcock E, Howlett K, et al. Galectin 3 induces a distinctive pattern of cytokine and chemokine production in rheumatoid synovial fibroblasts via selective signaling pathways. Arthritis Rheumatism: Official J Am Coll Rheumatol. 2009;60(6):1604\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhang BY, Fang Y, Jiao XY, Wu S, Cai JR, Zou JZ, et al. Delayed ischaemic preconditioning in the presence of galectin-9 protects against renal ischaemic injury through a regulatory T‐cell dependent mechanism. Nephrology. 2016;21(10):828\u0026ndash;34.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDang Z, MacKinnon A, Marson LP, Sethi T. Tubular atrophy and interstitial fibrosis after renal transplantation is dependent on galectin-3. Transplantation. 2012;93(5):477\u0026ndash;84.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRizk MM, Elsayed ET, ElKeraie AF, Ramzy I. Association of tumor necrosis factor alpha-induced protein 3 interacting protein 1 (TNIP1) gene polymorphism (rs7708392) with lupus nephritis in Egyptian patients. Biochem Genet. 2018;56:478\u0026ndash;88.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFloege J, Boor P, Moeller M. What is certain in the treatment of glomerulonephritis? Der Internist. 2018;59:1268\u0026ndash;78.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eYap DY, Tang CS, Ma MK, Lam MF, Chan TM. Survival analysis and causes of mortality in patients with lupus nephritis. Nephrol Dialysis Transplantation. 2012;27(8):3248\u0026ndash;54.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eParikh SV, Almaani S, Brodsky S, Rovin BH. Update on lupus nephritis: core curriculum 2020. Am J Kidney Dis. 2020;76(2):265\u0026ndash;81.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDesmedt V, Desmedt S, Delanghe JR, Speeckaert R, Speeckaert MM. Galectin-3 in renal pathology: more than just an innocent bystander? Am J Nephrol. 2016;43(5):305\u0026ndash;17.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKang E, Moon K, Lee E, Lee Y, Lee E, Ahn C, et al. Renal expression of galectin-3 in systemic lupus erythematosus patients with nephritis. Lupus. 2009;18(1):22\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhao CN, Mao YM, Liu LN, Wu Q, Dan YL, Pan HF. Plasma galectin-3 levels do not differ in systemic lupus erythematosus patients. Int J Rheum Dis. 2019;22(10):1820\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDing H, Shen Y, Lin C, Qin L, He S, Dai M, et al. Urinary galectin-3 binding protein (G3BP) as a biomarker for disease activity and renal pathology characteristics in lupus nephritis. Arthritis Res Therapy. 2022;24(1):1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOu S-M, Tsai M-T, Chen H-Y, Li F-A, Tseng W-C, Lee K-H, et al. Identification of galectin-3 as potential biomarkers for renal fibrosis by RNA-sequencing and clinicopathologic findings of kidney biopsy. Front Med. 2021;8:748225.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAbe M, Akaishi T, Miki T, Miki M, Funamizu Y, Araya K, et al. Influence of renal function and demographic data on intrarenal Doppler ultrasonography. PLoS ONE. 2019;14(8):e0221244.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChen Q, He F, Feng X, Luo Z, Zhang J, Zhang L, et al. Correlation of Doppler parameters with renal pathology: A study of 992 patients. Experimental therapeutic Med. 2014;7(2):439\u0026ndash;42.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLiu Y. Cellular and molecular mechanisms of renal fibrosis. Nat Rev Nephrol. 2011;7(12):684\u0026ndash;96.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBig\u0026eacute; N, L\u0026eacute;vy PP, Callard P, Faintuch J-M, Chigot V, Jousselin V, et al. Renal arterial resistive index is associated with severe histological changes and poor renal outcome during chronic kidney disease. BMC Nephrol. 2012;13(1):1\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKimura N, Kimura H, Takahashi N, Hamada T, Maegawa H, Mori M, et al. Renal resistive index correlates with peritubular capillary loss and arteriosclerosis in biopsy tissues from patients with chronic kidney disease. Clin Exp Nephrol. 2015;19:1114\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRadermacher J, Mengel M, Ellis S, Stuht S, Hiss M, Schwarz A, et al. The renal arterial resistance index and renal allograft survival. N Engl J Med. 2003;349(2):115\u0026ndash;24.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable (1) Comparison of demographic, laboratory and duplex sonography results between NN, GN and LN groups:\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup 1(NN)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup 2(GN)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup 3(LN)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e31.50 (25.75-39.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e34.5(26-53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e28.5(21.5-35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.060\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003cp\u003eMale n (%)\u003c/p\u003e\n \u003cp\u003eFemale n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0(0)\u003c/p\u003e\n \u003cp\u003e30(100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e18(60)\u003c/p\u003e\n \u003cp\u003e12(40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3(10)\u003c/p\u003e\n \u003cp\u003e27(90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eSLE duration (years)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e4.5(0.87-6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e0(0-0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.5(0.5-5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.134\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eCreatinine (mg/dl)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0.9(0.67-1)\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e1.2(0.9-2.65)\u003cstrong\u003e\u003csup\u003e1,2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.8(0.6-1.55)\u003cstrong\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eserum albumin (g/dl)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e4(3.5-4)\u003cstrong\u003e\u003csup\u003e1,2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e2.35(1.8-3.5)\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e3(2.475-3.1)\u003cstrong\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eANA (IU/ml)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e23(18.2-40)\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e0(0-0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e95(60-192)\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eanti dsDNA (IU/ml)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e11(10-20)\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e0(0-0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e75(30-147)\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eESR (mm/hr)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e40(30-80)\u003cstrong\u003e\u003csup\u003e1,2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e85(58.75-111.25)\u003cstrong\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e83.5(51.2-100)\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eGalectin-3 (ng/ml)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0.41(0.25-0.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e0.27(0.15-0.57)\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.56(0.25-0.96)\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.022\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e24-hour urinary protein (g/ day)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0.17(0.1-0.22)\u003cstrong\u003e\u003csup\u003e1,2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e5.5(4.3-7.25)\u003cstrong\u003e\u003csup\u003e2,3\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2.95(2-3.2)\u003cstrong\u003e\u003csup\u003e1,3\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eKidney length (cm)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e10.65(10.34-11.025)\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e11.45(10.68-11.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e11.47(10.95-12.01)\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.010\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eKidney transverse diameter (cm)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e4.65(4.34-5)\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e5(4.75-5.25)\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4.825(4.63-5.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.034\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eMain art RI\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0.56 (0.527-0.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e0.58(0.53-0.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.58 (0.53-0.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.875\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eMain art PSV (cm/s)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e41.93\u0026plusmn;7.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e37.88\u0026plusmn;9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e43.69\u0026plusmn;12.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.084\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eMain art EDV (cm/s)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e16.9 (14.77-20.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e15.95(11.18-19.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e16.63 (13.4-20.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.875\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eInterlobar RI\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e0.56(0.53-0.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e0.56(0.53-0.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.59(0.53-0.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.113\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eInterlobar PSV (cm/s)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e34.4\u0026plusmn;5.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e32.67\u0026plusmn;7.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e34.92\u0026plusmn;8.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.474\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eInterlobar EDV (cm/s)\u003c/p\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e16.9(14.775-20.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e13.95\u0026plusmn;4.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e16.62(13.4-20.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.593\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (2) pattern of GN and classes of lupus nephritis across the studied groups:\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 342px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGN types\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLN classes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eMembranous n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e5\u003cspan dir=\"RTL\"\u003e)\u003c/span\u003e16.7\u003cspan dir=\"RTL\"\u003e(\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eClass 1 n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e1\u003cspan dir=\"RTL\"\u003e)\u003c/span\u003e3.3\u003cspan dir=\"RTL\"\u003e(\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eFSGS n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e14\u003cspan dir=\"RTL\"\u003e)\u003c/span\u003e46.7\u003cspan dir=\"RTL\"\u003e(\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eClass 2 n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e2\u003cspan dir=\"RTL\"\u003e)\u003c/span\u003e6.7\u003cspan dir=\"RTL\"\u003e(\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eminimal change n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e4\u003cspan dir=\"RTL\"\u003e)\u003c/span\u003e13.3\u003cspan dir=\"RTL\"\u003e(\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eClass 3 n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e5\u003cspan dir=\"RTL\"\u003e)\u003c/span\u003e16.7\u003cspan dir=\"RTL\"\u003e(\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eIgM nephropathy n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1\u003cspan dir=\"RTL\"\u003e)\u003c/span\u003e3.3\u003cspan dir=\"RTL\"\u003e(\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eClass 4 n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e15\u003cspan dir=\"RTL\"\u003e)\u003c/span\u003e50.0\u003cspan dir=\"RTL\"\u003e(\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eMPGN n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e4\u003cspan dir=\"RTL\"\u003e)\u003c/span\u003e13.3\u003cspan dir=\"RTL\"\u003e(\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eClass 5 n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e5\u003cspan dir=\"RTL\"\u003e)\u003c/span\u003e16.7\u003cspan dir=\"RTL\"\u003e(\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003emesangial proliferative n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e2\u003cspan dir=\"RTL\"\u003e)\u003c/span\u003e6.7\u003cspan dir=\"RTL\"\u003e(\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eClass 4+5 n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e2\u003cspan dir=\"RTL\"\u003e)\u003c/span\u003e6.7\u003cspan dir=\"RTL\"\u003e(\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (3) Correlation between renal duplex and different variables across all the 3 groups:\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMain artery RI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMain artery PSV\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInterlobar artery RI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInterlobar artery PSV\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003eR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003eR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003eR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.191\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.072\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-0.211\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.046\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e0.152\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.152\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-0.185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.081\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eCreatinine (mg/dl)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.224\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.034\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e-0.204\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e0.062\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.560\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-0.187\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.078\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eserum albumin (g/dl)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.798\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e-0.065\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.543\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e-0.067\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.532\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-0.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.196\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eANA (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.438\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.713\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e0.130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.222\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.887\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eanti dsDNA (IU/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.032\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.762\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.166\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.118\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e0.042\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.691\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.323\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e24-hour urinary protein (g/day)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-0.021\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.842\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e-0.073\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.496\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e-0.021\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.844\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.546\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eGalectin-3\u0026nbsp;(ng/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.194\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e-0.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.692\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e0.199\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.057\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.592\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eESR (mm/hr)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.018\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.868\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e-0.104\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.331\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e-0.015\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.890\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-0.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.419\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (4) Correlation between renal duplex and renal histopathology of LN group:\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMain RI\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMain art PSV\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInterlobar RI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInterlobar artery PSV\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003eR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003eR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003etotal percent of glomerulosclerosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.613\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.557\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.375\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.041\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e-0.310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.096\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eHypercellularity percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.986\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.285\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e0.381\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e-0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.759\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003ecellular crescent percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.098\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.606\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.318\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.087\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e0.538\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e-0.212\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.262\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003efibrous crescent percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.124\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.515\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e0.372\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e-0.208\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.271\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003ehyaline percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.085\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.655\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e0.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e0.190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.316\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003efibrinoid necrosis percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.495\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.234\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e0.550\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e0.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.882\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eneutrophil karyorrhexis percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.091\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.632\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.247\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e0.424\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e0.078\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.683\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eTubular atrophy percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.511\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.493\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0415\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.023\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e-0.163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.389\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003einterstitial fibrosis percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.571\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.546\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.395\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.031\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e-0.152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.423\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003einterstitial inflammatory infiltrate percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.362\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.049\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e0.159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e-0.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.535\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eActivity index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.311\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.237\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e0.945\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e-0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.737\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eChronicity index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.647\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.193\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.307\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.374\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.041\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e-0.232\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.218\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (5) Correlation between renal duplex and renal histopathology of GN groups:\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"648\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMain artery RI\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMain artery PSV\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInterlobar artery RI\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInterlobar artery PSV\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003eR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003eR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003eR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eTotal percent of glomerulosclerosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.415\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.022\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-0.473\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.008\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e-0.291\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.119\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eHypercellularity percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e-0.223\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.235\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-0.233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.215\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.943\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e-0.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.884\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eCellular crescent percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e-0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.829\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-0.305\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.251\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.181\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.279\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.135\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eFibrous crescent percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.469\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-0.261\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.210\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.264\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eTubular atrophy percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.298\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-0.542\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e-0.298\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.110\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eInterstitial fibrosis percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.417\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.022\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-0.407\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.026\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.296\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e-0.216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.251\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eInterstitial inflammatory infiltrate percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.501\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-0.220\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e-0.171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.365\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e-0.156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.410\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (6) correlation of galectin-3 with histopathology of GN group:\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003etotal percent of glomerulosclerosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.413\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003eHypercellularity percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.227\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.228\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003eTubular atrophy percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e-0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.982\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003einterstitial fibrosis percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.665\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003einterstitial inflammatory infiltrate percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.276\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.140\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (7) Correlation of galectin 3 with histopathology of LN group:\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 324px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 324px;\"\u003e\n \u003cp\u003etotal percent of glomerulosclerosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.388\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.034\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 324px;\"\u003e\n \u003cp\u003eHypercellularity percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-0.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.623\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 324px;\"\u003e\n \u003cp\u003ecellular crescent percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.662\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 324px;\"\u003e\n \u003cp\u003efibrous crescent percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.737\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 324px;\"\u003e\n \u003cp\u003ehyaline percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.364\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.048\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 324px;\"\u003e\n \u003cp\u003efibrinoid necrosis percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-0.134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.481\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 324px;\"\u003e\n \u003cp\u003eneutrophil karyorrhexis percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-0.068\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.721\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 324px;\"\u003e\n \u003cp\u003eTubular atrophy percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.341\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 324px;\"\u003e\n \u003cp\u003einterstitial fibrosis percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.302\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 324px;\"\u003e\n \u003cp\u003einterstitial inflammatory infiltrate percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.361\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 324px;\"\u003e\n \u003cp\u003eActivity index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e0.122\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e0.521\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 324px;\"\u003e\n \u003cp\u003eChronicity index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e0.309\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e0.097\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e\u003c/span\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (8) correlation of Galectin-3 with lupus biomarkers:\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eANA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e-0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.631\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003eAnti ds DNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.768\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (9) Multivariate regression analysis of main artery RI:\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBeta\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95.0% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e(Constant)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.546\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(0.491-0.602)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eAge(years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e-0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e-0.112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(-0.003-0.001)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.343\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eCreatinine (mg/dl)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.025\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.494\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(0.010-0.039)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003einterstitial fibrosis percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(0.000-0.002)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.069\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (10) Multivariate regression analysis of interlobar artery RI:\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBeta\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95.0% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e(Constant)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.537\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(0.493-0.582)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(-0.001-0.002)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.683\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003eCreatinine (mg/dl)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.014\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.393\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(0.002-0.025)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.022\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003einterstitial fibrosis percent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.084\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e(-0.001-0.001)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.597\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Lupus nephritis, glomerulonephritis, Galectin-3, renal histopathology, renal artery doppler","lastPublishedDoi":"10.21203/rs.3.rs-7374078/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7374078/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e\u003cp\u003eGalectin-3 demonstrates multifunctionality with diverse biological roles. Its potential as a biomarker for inflammation and renal fibrosis has gathered attention. The renal doppler is commonly used as a guide for intrarenal arterial resistance and has a role in the differential diagnosis of various nephropathies. Their role in predicting and diagnosing lupus nephritis (LN) groups needs to be investigated.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethod\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis is a cross-sectional study which included 90 patients and assigned into: group 1 (patients with SLE without nephritis (NN), group 2 (patients with nephritis other than SLE (GN) and group 3 (patients with LN). Serum Galectin-3 and renal doppler ultrasound were applied and correlated with other laboratory and histopathology data.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e\u003cp\u003eGalectin-3 was significantly higher in LN group than GN group. Galectin-3 has no significant correlation with interlobar artery RI. in patients with LN, Galectin-3 has positive correlation with both of total percent of glomerulosclerosis and hyaline percent but no significant correlation with activity or chronicity indices. Also, total percent of glomerulosclerosis correlated positively with main artery. The chronicity index positively correlated with the main artery RI. On the other hand, no significant correlation was observed between main artery RI and activity index. Regarding patients with GN, total percent of glomerulosclerosis positively correlated with main artery RI. Interstitial fibrosis positively correlated with main artery RI. Galectin-3 has no statistically significant correlation interstitial fibrosis or tubular atrophy in GN group.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e\u003cp\u003eGalectin-3 was higher in LN patients than other causes of GN. However, its role as an inflammatory marker is not confirmed by our study in correlation with lupus biomarkers or histopathological activity. Results of renal artery doppler agreed with the previous studies. Main renal artery RI was significantly correlate with the percent of glomerulosclerosis and interstitial fibrosis in both LN and GN groups.\u003c/p\u003e","manuscriptTitle":"The predictive role of Galectin-3 and renal arterial resistive index in patients with lupus nephritis versus other glomerulopathies","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-17 16:50:36","doi":"10.21203/rs.3.rs-7374078/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0609ecf9-72e7-41ba-a822-1773f3679df8","owner":[],"postedDate":"September 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-10T08:09:17+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-17 16:50:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7374078","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7374078","identity":"rs-7374078","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}