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WHAT IS IT?
Lupus nephritis is a type III hypersensitivity reaction/autoimmune disorder (in patients with systemic lupus erythematosus/SLE) that can have various different presentations which include:
- Nephritic: diffuse proliferative glomerulonephritis (most common)
- Nephrotic: membranous glomerulonephritis
*These are only a few examples, lupus can cause many different types of kidney damage!
WHY IS IT A PROBLEM?
SLE is an autoimmune disorder that is characterized by the presence of auto-antiobides to nuclear antigens (ANAs). These ANAs can lead to immune complex deposition in the kidneys causing glomerulonephritis (inflammation of the glomerulus) and ultimately kidney failure.
WHAT MAKES US SUSPECT IT?
Risk factors: lupus diagnosis, male
Often asymptomatic and lupus nephritis does not have many characteristic findings.
Leg swelling and other forms of edema are possible if patient has nephrotic syndrome.
HOW DO WE CONFIRM A DIAGNOSIS?
The diagnosis of lupus nephritis is made in patients with confirmed SLE who also have any of the following:
- Persistent proteinuria
- Cellular casts in the urine
- Presence of blood/RBCs and/or WBCs in the urine
Renal biopsy can confirm pathology of lupus nephritis.
HOW DO WE RULE OTHER DIAGNOSES OUT?
No single clinical or laboratory finding rules out lupus nephritis! By extension it is difficult to also rule out other cases for a patients urinary symptoms.
HOW DO WE TREAT IT?
Treatment will vary depending on the type of lupus nephritis the patient has, however often involves immunosuppressive therapies.
HOW WELL DO THE PATIENTS DO?
This condition is very variable depending on the clinical context.
WAS THERE A WAY TO PREVENT IT?
No clear means of preventing lupus nephritis are known.
WHAT ELSE ARE WE WORRIED ABOUT?
The underlying lupus nephritis which can cause a wide variety of other complications in the patient.
OTHER HY FACTS?
FURTHER READING
Page Updated: 02.07.2016