Clinical approach to lupus nephritis: recent advances.
Kidney involvement is common in systemic lupus erythematosus (SLE). Its clinical presentations are highly variable, ranging from mild asymptomatic proteinuria and/or hematuria to rapidly progressive uremia. Histological evidence of lupus nephritis is present in most patients with SLE, even when they do not yet have clinical manifestations. Current classification ISN/RPS 2003 (International Society of Nephrology/Renal Pathology Society) of lupus nephritis was promoted by a widely perceived need to re-examine existing classification, provide clearer distinctions between the histological classes, and improve diagnostic reproducibility and interobserver agreement. Lupus nephritis is a serious disease whose prognosis can usually be improved dramatically by treatment, but treatment is potentially toxic, prolonged, and complex. Current treatment regimens combine corticosteroids with cyclophosphamide, azathioprine or ciclosporin; mycophenolate mofetil has received much recent attention as a potentially immune suppressive agent and less aggressive immunosuppressive regimens can be prescribed. SLE patients should be regular followed to detect early kidney involvement.
Molino
C
C
Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy. clinicamedica@unife.it
Fabbian
F
F
Longhini
C
C
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008181:Lupus Nephritis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D011379:Prognosis; D012307:Risk Factors
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents