Lupus nephritis in children.
In systemic lupus erythematosus renal involvement is more frequent in children than in adults. Overall, 60-80% of children with systemic lupus erythematosus have urinary or renal function abnormalities early in the disease course. In 90% of patients, renal disease occurs within two years from disease onset. Clinically significant renal involvement ranges from asymptomatic urinary findings to nephrotic syndrome and renal failure. Long-term prognosis is similar to that observed in adults. Treatment aspects that are peculiar to children include drug side-effects, such as growth inhibition induced by steroids, the need to consider morbidity-related issues with respect to the very long life expectancy of patients and the problems related to the impact of disease in adolescents. The recent availability of a childhood SLE definition of improvement and the presence of large international paediatric rheumatology networks should, in the future, facilitate the implementation of controlled clinical trials devoted to paediatric SLE.
Perfumo
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F
Nephrology Unit, University of Genoa, Istituto G. Gaslini, Genoa, Italy.
Martini
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A
D000293:Adolescent; D000367:Age Factors; D000974:Antibodies, Antinuclear / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008181:Lupus Nephritis / Q000276:immunology / Q000628:therapy*; D008297:Male; D011379:Prognosis
D000974:Antibodies, Antinuclear