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Lupus nephritis

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associated with a higher risk of progression to end stage kidney disease. Black and Hispanic people with lupus nephritis are more likely to present with severe disease at initial presentation (with more proteinuria and more extensive histopathologic changes) and progress to end stage kidney disease. This is thought to be due to socioeconomic factors but auto-antibodies strongly associated with lupus nephritis such as anti-Sm, anti-Ro and anti-ribonucleoprotein are also more commonly seen in Black and Hispanic people. Men with SLE tend to have more aggressive forms of lupus nephritis as well with a higher risk of progression to end stage kidney disease and higher risk of concurrent cardiovascular disease.
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In those who have SLE, concomitant lupus nephritis is associated with a worse overall prognosis. 10-30% of people with lupus nephritis progress to kidney failure requiring dialysis, with the 5 year mortality rate of lupus nephritis being 5-25%. The proliferative forms of lupus nephritis are
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A tubuloreticular inclusion within capillary endothelial cells is also characteristic of lupus nephritis and can be seen under an electron microscope in all stages. It is not diagnostic however, as it exists in other conditions such as HIV infection.
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failure, immune problems or hair loss. It also works better than azathioprine with corticosteroids for maintenance therapy. A 2016 network meta-analysis, which included 32 RCTs of lupus nephritis, demonstrated that
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maintenance were associated with a lower risk of serious infection when compared to other immunosuppressants or glucocorticoids. Individuals with lupus nephritis have a high risk for
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Tang, Kuo-Tung; Tseng, Chien-Hua; Hsieh, Tsu-Yi; Chen, Der-Yuan (June 2018). "Induction therapy for membranous lupus nephritis: a systematic review and network meta-analysis".
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Tunnicliffe, David J.; Palmer, Suetonia C.; Henderson, Lorna; Masson, Philip; Craig, Jonathan C.; Tong, Allison; Singh-Grewal, Davinder; Flanc, Robert S.; Roberts, Matthew A.;
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Appel, Gerald B.; Contreras, Gabriel; Dooley, Mary Anne; Ginzler, Ellen M.; Isenberg, David; Jayne, David; Li, Lei-Shi; Mysler, Eduardo; Sánchez-Guerrero, Jorge (2009-05-01).
661:. MMF and cyclophosphamide with corticosteroids are equally effective in achieving remission of the disease, however the results of a recent systematic review found that 475:
lesions involving less than 50% of the glomeruli, which can be segmental or global, and active or chronic, with endocapillary or extracapillary proliferative lesions.
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contributing significantly. Autoantibodies direct themselves against nuclear elements. The characteristics of nephritogenic autoantibodies (lupus nephritis) are
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More than 50% of glomeruli are involved. Lesions can be segmental or global, and active or chronic, with endocapillary or extracapillary proliferative lesions.
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Active glomerulonephritis is not usually present. This stage is characterised by slowly progressive kidney dysfunction, with relatively bland urine sediment.
271:, and with immune system problems it cannot distinguish between harmful and healthy substances. Lupus nephritis affects approximately 3 out of 10,000 people. 2051: 2115: 422: 1943: 2125: 1977: 1973: 1306:
Singh, Jasvinder A.; Hossain, Alomgir; Kotb, Ahmed; Oliveira, Ana; Mudano, Amy S.; Grossman, Jennifer; Winthrop, Kevin; Wells, George A. (2016).
1467:"Risk of serious infections with immunosuppressive drugs and glucocorticoids for lupus nephritis: a systematic review and network meta-analysis" 2237: 2210: 2198: 2176: 2167: 1249:"Comparative effectiveness of immunosuppressive drugs and corticosteroids for lupus nephritis: a systematic review and network meta-analysis" 1195: 1095:"National Guideline Clearinghouse | American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis" 778: 1967: 1963: 383: 665:
were better than corticosteroids for renal outcomes. MMF is safer than cyclophosphamide with corticosteroids, with less chance of causing
504:. Clinically, haematuria and proteinuria are present, with or without nephrotic syndrome, hypertension, and elevated serum creatinine. 2092: 1679: 1658: 1231: 1689:
Castro-Santana, Lesliane E.; Colón, Marilú; Molina, María J.; Rodríguez, Vanessa E.; Mayor, Angel M.; Vilá, Luis M. (2010-01-01).
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wall (segmentally or globally), with diffuse membrane thickening, and subepithelial deposits seen under the electron microscope.
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has divided lupus nephritis into five stages based on the biopsy. This classification was defined in 1982 and revised in 1995.
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of diffuse proliferative lupus nephritis showing increased mesangial matrix and mesangial hypercellularity.
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Under electron microscopy, subendothelial deposits are noted, and some mesangial changes may be present.
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Clinically, haematuria and proteinuria are present, frequently with nephrotic syndrome, hypertension,
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become inflamed. Since it is a result of SLE, this type of glomerulonephritis is said to be
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involving more than 90% of glomeruli, and represents healing of prior inflammatory injury.
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Ponticelli, C.; Moroni, G. (2005-01-01). "Renal transplantation in lupus nephritis".
623: 296: 264: 181: 64: 1561: 1444: 1045:"The classification of glomerulonephritis in systemic lupus erythematosus revisited" 757: 2241: 2029: 1880: 1584:
Parikh, Samir V.; Almaani, Salem; Brodsky, Sergey; Rovin, Brad H. (1 August 2020).
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Singh, Jasvinder A.; Hossain, Alomgir; Kotb, Ahmed; Wells, George (2016-09-13).
229: 193: 1602: 733: 637: 17: 1818: 1814: 1483: 1308:"Treatments for Lupus Nephritis: A Systematic Review and Network Metaanalysis" 1265: 671: 586: 582: 436: 407: 340: 292: 234: 224: 177: 173: 169: 81: 60: 1757: 1706: 1611: 1545: 1492: 1384: 1333: 1274: 1247:
Singh, Jasvinder A.; Hossain, Alomgir; Kotb, Ahmed; Wells, George A. (2016).
1071: 1020: 1003: 864: 741: 581:. Microscopic haematuria and hypertension may also be seen. Can also lead to 478:
Subendothelial deposits are noted, and some mesangial changes may be present
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cause originating in the kidney. The diagnosis of lupus nephritis depends on
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predisposition, plays a significant role in lupus nephritis. Multiple
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Diffuse proliferative lupus nephritis as seen in a pathology specimen
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Weening JJ, D'Agati VD, Schwartz MM, et al. (February 2004).
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immune complexes, and autoantibodies of certain isotypes activate
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titres and elevated serum creatinine. Kidney failure is common.
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Often successfully responds to high doses of corticosteroids
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Saxena, Ramesh; Mahajan, Tina; Mohan, Chandra (2011-01-01).
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Drug regimens prescribed for lupus nephritis include
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Lewis, Edmund J.; Schwartz, Melvin M. (2010-11-04).
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Saudi Journal of Kidney Diseases and Transplantation
2272: 2236: 2197: 2175: 2159: 2134: 2106: 2078: 2067: 1855: 1791: 1668:Greenberg, Arthur; Cheung, Alfred K. (2005-01-01). 812:"Lupus nephritis: MedlinePlus Medical Encyclopedia" 123: 113: 105: 95: 75: 40: 35: 1183: 1123:Karageorgas TP, Tseronis DD, Mavragani CP (2011). 184:. On urinalysis, a nephritic picture is found and 1586:"Update on Lupus Nephritis: Core Curriculum 2020" 953:"Lupus Nephritis: An Overview of Recent Findings" 653:with corticosteroids, and the immune suppressant 430:Mesangial hypercellularity and matrix expansion. 1182:Elizabeth D Agabegi; Agabegi, Steven S. (2008). 897:"Lupus Nephritis - National Library of Medicine" 2260:Eosinophilic granulomatosis with polyangiitis 2045: 1937: 1738:Journal of the American Society of Nephrology 109:Complication of systemic lupus erythematosus. 8: 550:Corticosteroids and immunosuppressant drugs 204:General symptoms of lupus nephritis include 1526:International Journal of Rheumatic Diseases 1365:The Cochrane Database of Systematic Reviews 920: 918: 916: 682:(which begins in the immune system cells). 2172: 2075: 2052: 2038: 2030: 1944: 1930: 1922: 1788: 1129:Journal of Biomedicine & Biotechnology 454:Responds to high doses of corticosteroids 423:Mesangial proliferative glomerulonephritis 86: 51: 32: 1765: 1714: 1601: 1579: 1577: 1575: 1573: 1571: 1500: 1482: 1392: 1359:; Strippoli, Giovanni Fm (29 June 2018). 1323: 1282: 1264: 1150: 1140: 1070: 1060: 1019: 978: 968: 872: 854: 439:with or without proteinuria may be seen. 1215: 1213: 1211: 1209: 1207: 636: 345: 2126:Membranoproliferative/mesangiocapillary 1978:Mesangial proliferative lupus nephritis 773: 771: 769: 767: 712: 806: 804: 802: 800: 798: 605:Advanced sclerosing lupus nephritis. 568:Diffuse thickening of the glomerular 7: 1968:Minimal mesangial glomerulonephritis 1186:Step-Up to Medicine (Step-Up Series) 384:Minimal mesangial glomerulonephritis 295:, high affinity autoantibodies form 1590:American Journal of Kidney Diseases 1062:10.1097/01.ASN.0000108969.21691.5D 406:is very rare in this form. Normal 370:Clinical findings and other tests 25: 837:"Lupus nephritis: current update" 2250:Granulomatosis with polyangiitis 2061:Disease of the kidney glomerules 1895: 1226:. OUP Oxford. pp. 174–177. 842:Arthritis Research & Therapy 252:The cause of lupus nephritis, a 1998:Diffuse proliferative nephritis 518:Diffuse proliferative nephritis 337:Diffuse proliferative nephritis 1377:10.1002/14651858.CD002922.pub4 593:. Kidney failure is uncommon. 397:deposits are visible under an 1: 1988:Focal proliferative nephritis 561:Membranous glomerulonephritis 451:are very rare at this stage. 267:protects the human body from 119:Complement levels, Urinalysis 1674:. Elsevier Health Sciences. 1650:Systemic Lupus Erythematosus 180:scans of the kidneys, and a 146:systemic lupus erythematosus 2121:Endocapillary proliferative 1312:The Journal of Rheumatology 127:Corticosteroids may be used 27:Inflammation of the kidneys 2327: 1603:10.1053/j.ajkd.2019.10.017 734:10.1191/0961203305lu2067oa 2203:Type III hypersensitivity 1959: 1671:Primer on Kidney Diseases 1484:10.1186/s12916-016-0673-8 1266:10.1186/s13643-016-0328-z 951:Salgado, Alberto (2012). 330:World Health Organization 59: 50: 2255:Microscopic polyangiitis 2181:Type II hypersensitivity 1021:10.4103/1319-2442.132169 589:thromboses or pulmonary 465:Focal glomerulonephritis 291:specificity directed at 2116:Mesangial proliferative 1695:Ethnicity & Disease 1538:10.1111/1756-185X.13321 1416:Masson, Philip (2011). 663:immunosuppressive drugs 484:reveals positively for 283:of lupus nephritis has 1750:10.1681/ASN.2008101028 642: 585:complications such as 546: 316: 315:Membranous nephropathy 101:Joint pain or swelling 2221:diffuse proliferative 1325:10.3899/jrheum.160041 647:mycophenolate mofetil 640: 544: 314: 2189:Goodpasture syndrome 2008:Membranous nephritis 674:and MMF followed by 186:red blood cell casts 1142:10.1155/2011/273907 1049:J. Am. Soc. Nephrol 970:10.1155/2012/849684 957:Autoimmune Diseases 701:Glomerulus (kidney) 649:(MMF), intravenous 449:acute kidney injury 399:electron microscope 366:Electron microscopy 347: 220:High blood pressure 2285:glomerulonephrosis 2280:glomerulonephritis 2211:Post-streptococcal 2018:Glomerulosclerosis 1856:External resources 1653:. Academic Press. 1357:Webster, Angela C. 1253:Systematic Reviews 643: 579:nephrotic syndrome 547: 533:hypocomplementemia 482:Immunofluorescence 445:nephrotic syndrome 391:Normal appearance 346: 335:Class IV disease ( 317: 200:Signs and symptoms 154:glomerulonephritis 152:. It is a type of 150:autoimmune disease 2293: 2292: 2268: 2267: 2155: 2154: 2080:Non-proliferative 2027: 2026: 1890: 1889: 1645:Lahita, Robert G. 1437:10.1111/nep.12011 1318:(10): 1801–1815. 1197:978-0-7817-7153-5 1099:www.guideline.gov 1072:20.500.12648/8229 1002:Kfoury H (2014). 783:www.niddk.nih.gov 779:"Lupus Nephritis" 630: 629: 626:is usually poor. 131: 130: 115:Diagnostic method 30:Medical condition 16:(Redirected from 2318: 2173: 2076: 2054: 2047: 2040: 2031: 1946: 1939: 1932: 1923: 1899: 1898: 1789: 1779: 1769: 1744:(5): 1103–1112. 1728: 1718: 1701:(1): S1–116–21. 1685: 1664: 1631: 1630: 1628: 1626: 1605: 1581: 1566: 1565: 1532:(6): 1163–1172. 1521: 1515: 1514: 1504: 1486: 1462: 1456: 1455: 1453: 1451: 1422: 1413: 1407: 1406: 1396: 1352: 1346: 1345: 1327: 1303: 1297: 1296: 1286: 1268: 1244: 1238: 1237: 1217: 1202: 1201: 1189: 1178: 1165: 1164: 1154: 1144: 1120: 1114: 1113: 1111: 1110: 1101:. Archived from 1091: 1085: 1084: 1074: 1064: 1040: 1034: 1033: 1023: 999: 993: 992: 982: 972: 948: 942: 941: 939: 937: 922: 911: 910: 908: 907: 893: 887: 886: 876: 858: 832: 826: 825: 823: 822: 808: 793: 792: 790: 789: 775: 762: 761: 717: 651:cyclophosphamide 641:Cyclophosphamide 535:, elevated anti- 361:Light microscopy 348: 91: 90: 55: 33: 21: 2326: 2325: 2321: 2320: 2319: 2317: 2316: 2315: 2311:Kidney diseases 2296: 2295: 2294: 2289: 2264: 2232: 2193: 2166: 2161: 2151: 2130: 2102: 2093:Focal segmental 2069: 2063: 2058: 2028: 2023: 1955: 1953:Lupus nephritis 1950: 1920: 1919: 1918: 1913:Lupus nephritis 1900: 1896: 1891: 1886: 1885: 1851: 1850: 1800: 1786: 1731: 1688: 1682: 1667: 1661: 1643: 1640: 1638:Further reading 1635: 1634: 1624: 1622: 1583: 1582: 1569: 1523: 1522: 1518: 1464: 1463: 1459: 1449: 1447: 1420: 1415: 1414: 1410: 1371:(6): CD002922. 1354: 1353: 1349: 1305: 1304: 1300: 1246: 1245: 1241: 1234: 1223:Lupus Nephritis 1219: 1218: 1205: 1198: 1181: 1179: 1168: 1122: 1121: 1117: 1108: 1106: 1093: 1092: 1088: 1042: 1041: 1037: 1001: 1000: 996: 950: 949: 945: 935: 933: 932:. 30 March 2023 924: 923: 914: 905: 903: 895: 894: 890: 834: 833: 829: 820: 818: 816:www.nlm.nih.gov 810: 809: 796: 787: 785: 777: 776: 765: 719: 718: 714: 709: 697: 688: 680:B-cell lymphoma 659:corticosteroids 635: 326: 309: 281:pathophysiology 277: 275:Pathophysiology 250: 245: 202: 190:red blood cells 134:Lupus nephritis 85: 36:Lupus nephritis 31: 28: 23: 22: 18:Lupus Nephritis 15: 12: 11: 5: 2324: 2322: 2314: 2313: 2308: 2298: 2297: 2291: 2290: 2288: 2287: 2282: 2276: 2274: 2270: 2269: 2266: 2265: 2263: 2262: 2257: 2252: 2246: 2244: 2234: 2233: 2231: 2230: 2225: 2224: 2223: 2213: 2207: 2205: 2195: 2194: 2192: 2191: 2185: 2183: 2170: 2157: 2156: 2153: 2152: 2150: 2149: 2144: 2138: 2136: 2132: 2131: 2129: 2128: 2123: 2118: 2112: 2110: 2104: 2103: 2101: 2100: 2095: 2090: 2088:Minimal change 2084: 2082: 2073: 2065: 2064: 2059: 2057: 2056: 2049: 2042: 2034: 2025: 2024: 2022: 2021: 2011: 2001: 1991: 1981: 1971: 1960: 1957: 1956: 1951: 1949: 1948: 1941: 1934: 1926: 1901: 1894: 1893: 1892: 1888: 1887: 1884: 1883: 1872: 1860: 1859: 1857: 1853: 1852: 1849: 1848: 1837: 1822: 1801: 1796: 1795: 1793: 1792:Classification 1785: 1784:External links 1782: 1781: 1780: 1729: 1686: 1681:978-1416023128 1680: 1665: 1659: 1647:(2004-06-09). 1639: 1636: 1633: 1632: 1596:(2): 265–281. 1567: 1516: 1457: 1408: 1347: 1298: 1239: 1232: 1203: 1196: 1180:Table 6-4 in: 1166: 1115: 1086: 1035: 994: 943: 912: 888: 856:10.1186/ar3378 827: 794: 763: 711: 710: 708: 705: 704: 703: 696: 693: 687: 684: 634: 631: 628: 627: 620: 617: 615: 608: 606: 603: 597: 596: 594: 575: 573: 566: 563: 558: 552: 551: 548: 529: 526: 523: 520: 515: 509: 508: 505: 479: 476: 470: 467: 462: 456: 455: 452: 433: 431: 428: 425: 420: 414: 413: 411: 404:Kidney failure 401: 392: 389: 386: 381: 375: 374: 371: 368: 363: 358: 355: 352: 325: 324:Classification 322: 308: 305: 276: 273: 249: 246: 244: 243: 237: 232: 227: 222: 217: 212: 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Index

Lupus Nephritis

Micrograph
Kidney biopsy
PAS stain
Specialty
Nephrology
Edit this on Wikidata
Symptoms
Diagnostic method
inflammation
kidneys
systemic lupus erythematosus
autoimmune disease
glomerulonephritis
glomeruli
blood tests
urinalysis
ultrasound
kidney biopsy
red blood cell casts
red blood cells
proteinuria
Fever
Edema
High blood pressure
Joint pain
Muscle pain
Malar rash
urine

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