Lupus Nephritis

Excerpt

Systemic lupus erythematosus (SLE) is an autoimmune disease that causes chronic inflammation and damage to multiple organs. This condition is diagnosed clinically and serologically with the presence of autoantibodies. Hippocrates first documented a case of lupus in 400 BCE, and in the 18th and 19th centuries, SLE was believed to be associated with tuberculosis or syphilis. Over time, the understanding of lupus evolved from being seen as solely a dermatologic manifestation to being recognized as a comprehensive multisystemic disease.

A common and severe manifestation of SLE that requires evaluation is kidney involvement, referred to as "lupus nephritis." Monitoring kidney function in patients with SLE is crucial, as early detection and management of renal impairment can significantly improve outcomes. Lupus nephritis typically develops 3 to 5 years after the onset of SLE. Histological evidence of lupus nephritis is present in most SLE patients, even when clinical signs of renal disease are not apparent.

Monitoring for the development of lupus nephritis involves serial assessments of creatinine levels, urine protein-to-creatinine ratio, and urinalysis. These tests help detect increases in serum creatinine and the presence of proteinuria, which is commonly observed in lupus nephritis. Given the high risk of increased morbidity, timely treatment is crucial to prevent progression to end-stage renal disease (ESRD). The primary objective of treatment is to normalize kidney function or, at the very least, prevent further decline. Treatment options vary significantly based on the underlying pathological lesions.