Lupus nephritis
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| Lupus nephritis Classification and external resources | |
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| Type IV lupus nephritis: The classic "flea-bitten" appearance of the cortical surface in the diffuse proliferative glomerulonephritides. (Courtesy of Ed Uthman, MD)]] | |
| ICD-10 | N08.5 |
| ICD-9 | 583.81 |
| MedlinePlus | 000481 |
| eMedicine | med/1597 |
| MeSH | D008181 |
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Ongoing Trials on Lupus nephritis at Clinical Trials.gov Trial results on Lupus nephritis Clinical Trials on Lupus nephritis at Google
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US National Guidelines Clearinghouse on Lupus nephritis NICE Guidance on Lupus nephritis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753
Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
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Lupus nephritis is an inflammation of the kidney caused by systemic lupus erythematosus (SLE), a disease of the immune system. Apart from the kidneys, SLE can also damage the skin, joints, nervous system and virtually any organ or system in the body.
Signs and symptoms
Sufferers of lupus nephritis may or may not have symptoms of kidney disease, but it can manifest itself through weight gain, high blood pressure, darker foamy urine or swelling around the eyes, legs, ankles or fingers.
Furthermore, patients may suffer from other symptoms of lupus unrelated to kidney function. Such symptoms can include arthritis, fevers, gastro-intenstinal disturbances, headaches, fatigue, and fluid in the joints.
Diagnosis
The diagnosis of lupus nephritis depends on blood tests, urinalysis, X-rays, ultrasound scans of the kidneys, and a kidney biopsy. The World Health Organization has divided lupus nephritis into five classes based on the biopsy.
- Class I is histologically normal and does not show any evidence of disease.
- Class II is based on a finding of mesangial lupus nephritis. This form typically responds completely to treatment with corticosteroids.
- Class III is focal proliferative nephritis and often successfully responds to treatment with high doses of corticosteroids.
- Class IV is diffuse proliferative nephritis. This form is mainly treated with corticosteroids and immunosuppressant drugs.
- Class V is membranous nephritis and is characterized by extreme edema and protein loss.
- Class VI Glomerulosclerosis
Medicines which decrease swelling, lower blood pressure and decrease inflammation by suppressing the immune system. Patients may need to monitor intake of protein, sodium, and potassium. Patients with severe disease should restrict their sodium intake to 2 grams per day and limit fluid as well. Depending on the histology, renal function and degree of proteinuria, patients may require steroid therapy or chemotherapy regimens such as cyclophosphamide, azathioprine, mycophenolate mofetil or cyclosporine.
The medical therapy for lupus nephritis depends on the severity of the disease. For mild disease, corticosteroids are generally prescribed. More severe disease requires treatment with immunosuppressant agents. The two most commonly used agents are mycophenolate mofetil and intravenous cyclophosphamide. One recent study compared these two drugs.[1] The authors showed that patients with Class III or IV disease are more likely to benefit from mycophenolate mofetil as compared to cyclophosphamide. As a result, mycophenolate mofetil is now considered to be the first-line therapy for this disease.
References
- ↑ Ginzler EM, Dooley MA, Aranow C, Kim MY, et al. "Mycophenolate Mofetil or Intravenous Cyclophosphamide for Lupus Nephritis." New England Journal of Medicine. 353:21. 2219-2229. 24 November 2005.
External links
- Lupus Nephritis Clinical Research Study
- London Lupus Centre - Treatment, Diagnosis, Research
- Lupus Foundation of America, Inc.
- Lupus Research Institute
- S.L.E. Lupus Foundation
- Lupus International
WikiDoc Research Resources for Lupus nephritis | |
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| Articles on Lupus nephritis | Most recent articles on Lupus nephritis • Most cited articles on Lupus nephritis • Review articles on Lupus nephritis • Articles on Lupus nephritis in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Lupus nephritis | Powerpoint slides on Lupus nephritis • Images of Lupus nephritis • Photos of Lupus nephritis • Podcasts & MP3s on Lupus nephritis • Videos on Lupus nephritis |
| Evidence Based Medicine Regarding Lupus nephritis | Cochrane Collaboration on Lupus nephritis • Bandolier on Lupus nephritis • TRIP on Lupus nephritis |
| Cost Effectiveness of Lupus nephritis | Cost Effectiveness of Lupus nephritis |
| Clinical Trials Involving Lupus nephritis | Ongoing Trials on Lupus nephritis at Clinical Trials.gov • Trial results on Lupus nephritis • Clinical Trials on Lupus nephritis at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Lupus nephritis | US National Guidelines Clearinghouse on Lupus nephritis • NICE Guidance on Lupus nephritis • NHS PRODIGY Guidance • FDA on Lupus nephritis • CDC on Lupus nephritis |
| Textbook Information on Lupus nephritis | Books and Textbook Information on Lupus nephritis |
| Pharmacology Resources on Lupus nephritis | Dosing of Lupus nephritis • Drug interactions with Lupus nephritis • Side effects of Lupus nephritis • Allergic reactions to Lupus nephritis • Overdose information on Lupus nephritis • Carcinogenicity information on Lupus nephritis • Lupus nephritis in pregnancy • Pharmacokinetics of Lupus nephritis • |
| Genetics, Pharmacogenomics, and Proteinomics of Lupus nephritis | Genetics of Lupus nephritis • Pharmacogenomics of Lupus nephritis • Proteomics of Lupus nephritis |
| Newstories on Lupus nephritis | Lupus nephritis in the news • Be alerted to news on Lupus nephritis • News trends on Lupus nephritis |
| Commentary on Lupus nephritis | Blogs on Lupus nephritis |
| Patient Resources on Lupus nephritis | Patient resources on Lupus nephritis • Discussion groups on Lupus nephritis • Patient Handouts on Lupus nephritis • Directions to Hospitals Treating Lupus nephritis • Risk calculators and risk factors for Lupus nephritis |
| Healthcare Provider Resources on Lupus nephritis | Symptoms of Lupus nephritis • Causes & Risk Factors for Lupus nephritis • Diagnostic studies for Lupus nephritis • Treatment of Lupus nephritis |
| Continuing Medical Education (CME) Programs on Lupus nephritis | CME Programs on Lupus nephritis |
| International Resources on Lupus nephritis | Lupus nephritis en Espanol • Lupus nephritis en Francais |
| Business Resources on Lupus nephritis | Lupus nephritis in the Marketplace • Patents on Lupus nephritis |
| Informatics Resources on Lupus nephritis | List of terms related to Lupus nephritis |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
