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World J Exp Med. Jun 20, 2026; 16(2): 119440
Published online Jun 20, 2026. doi: 10.5493/wjem.v16.i2.119440
Published online Jun 20, 2026. doi: 10.5493/wjem.v16.i2.119440
Forgotten compartment: Impact of tubulointerstitial inflammation and damage on renal outcomes in lupus nephritis from Saudi Arabia
Muhammad Abdul Mabood Khalil, Nihal Mohammed Sadagah, Hinda Hassan Khideer Mahmood, Rayan Mohammed H Alghamdi, Salem H Al-Qurashi, Center of Renal Diseases and Transplan
Fadel Alrowaie, Department of Internal Medicine, Nephrology Section, King Fahad Medical City, Riyadh 12231, Saudi Arabia
Abdullah Mohammed Almansour, Lama Alghamdi, Rawan A Al-Ghamdi, Department of Medicine, King Fahad Armed Forces Hospital, Jeddah 23311, Saudi Arabia
Ammar Elgadi, Faculty of Medicine, University of Khartoum, Khartoum 11115, Sudan
Author contributions: Al-Qurashi SH, Khalil MAM, and Sadagah NM conceived the study idea; Khalil MAM drafted the initial version and revised it; all authors critically reviewed it and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Review Committee of King Fahd Armed Forces Hospital, Jeddah (Ref: REC 902).
Informed consent statement: All patients or their next of kin provided informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data will be made available upon reasonable request.
Corresponding author: Muhammad Abdul Mabood Khalil, Center of Renal Diseases and Transplantation, King Fahad Armed Forces Hospital, Al Kurnaysh Br Road, Al Andalus, Jeddah 23311, Saudi Arabia. doctorkhalil1975@hotmail.com
Received: January 28, 2026
Revised: March 29, 2026
Accepted: April 15, 2026
Published online: June 20, 2026
Processing time: 136 Days and 1.9 Hours
Revised: March 29, 2026
Accepted: April 15, 2026
Published online: June 20, 2026
Processing time: 136 Days and 1.9 Hours
Core Tip
Core Tip: Although current lupus nephritis (LN) classifications focus mainly on glomerular lesions, tubulointerstitial involvement is frequent and clinically relevant. In this Saudi cohort, the presence of combined tubulointerstitial inflammation and damage was associated with proliferative disease, higher activity and chronicity scores, and poorer renal outcomes. These patients achieved remission more slowly and less often during follow-up. Baseline kidney function, systemic inflammation, and selected histologic features further influenced prognosis. Detailed assessment of the tubulointerstitial compartment may therefore add meaningful prognostic information in LN.