Lupus nephritis: Pathologic features, epidemiology and a guide to therapeutic decisions

L. M. Ortega, D. R. Schultz, O. Lenz, V. Pardo, G. N. Contreras

Research output: Contribution to journalReview article

128 Scopus citations

Abstract

Systemic lupus erythematosus may present with renal manifestations that frequently are difficult to categorize and lupus nephritis is an important predictor of poor outcome. The type and spectrum of renal injury may remain undiagnosed until full-blown nephritic and/or nephrotic syndrome appear with increased risk of end-stage renal disease. These abnormalities occur within the first few years after the diagnosis of lupus is made on clinical grounds and with the support of laboratory tests in high risk patients. An early renal biopsy is helpful in patients with an abnormal urinalysis and/or reduced glomerular filtration rate and the results form the basis for therapeutic decisions. The biopsy also provides vital prognostic information based on histological categorization of different types of lupus nephritis, the degree of activity, chronicity and the immunopathogenesis. In the current armamentarium, the use of cyclophosphamide and azathioprine and recently mycophenolate mofetil, reduce morbidity and maintenance therapies reduce the risk of end-stage renal disease. Clinical trials underway promise new, effective and safe immunosuppressive regimens for the treatment of proliferative lupus nephritis.

Original languageEnglish (US)
Pages (from-to)557-574
Number of pages18
JournalLupus
Volume19
Issue number5
DOIs
StatePublished - Apr 1 2010

    Fingerprint

Keywords

  • Drug therapy
  • Epidemiology
  • Lupus nephritis
  • Pathogenesis
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology

Cite this