Clinical and Manifestation of Lupus Nephritis
MetadataShow full item record
Systemic lupusery thematosus (SLE) is a chronic auto immune disease of unknown cause that can affect virtually any organ of the body. Immunologic abnormalities, especially the production of a number of anti nucleara ntibodies (ANA), area prominent feature of the disease. SLE patients present with variable clinical features ranging from mild joint and skin involvement to life-threatening renal, hematologic, or central nervous system involvement. The clinical heterogeneity of SLE and the lack of pathognomonic features or tests pose a diagnostic challenge for theclinician.1 One of the most common and severe manifestation in SLE is Lupus nephritis. LN is a glomerulonephritis characterized by the accumulation of immune complexes in glomeruli and often an inflammatory response in all kidney compartments. Over time inflammation leads to chronic damage of the renal parenchyma and loss of kidney function. 2 In the US, approximately 35% of adults with systemic lupus erythematosus (SLE) have clinical evidence of nephritis at the time of diagnosis, with an estimated total of 50–60% developing nephritis during the first 10 years of disease. The prevalence of nephritis is significantly higher in African AmericansandHispanicsthaninwhites,andishigherinmenthaninwomen.Renaldamageismorelikely to develop in nonwhite groups. Overall survival in patients with SLE is approximately 95% at 5 years after diagnosis and 92% at 10 years after diagnosis (5,6). The presence of lupus nephritis (LN) significantly reduces survival to approximately 88% at 10 years, with even lower survival in African Americans.3 SLE complicated by LN has a worse outcome than SLE without kidney involvement. Although there are treatment options for LN, its prognosis has remained unchanged in recent years. Early recognition and prompt treatment of LN are critical to improving outcomes.