abstract details

The summaries are free for public use. ARTHROS will continue to add and archive summaries of articles deemed relevant to ARTHROS by our Faculty.

Lupus nephritis

Author

Anders HJ1, Saxena R2, Zhao MH3,4, Parodis I5,6, Salmon JE7, Mohan C8. Nat Rev Dis Primers. 2020 Jan 23;6(1):7. doi: 10.1038/s41572-019-0141-9.

Author Information

1 Division of Nephrology, Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany.

2 Division of Nephrology, Department of Medicine, UT Southwestern Medical Center, Dallas, TX, USA.

3 Renal Division, Peking University First Hospital, Beijing, China.

4 Peking-Tsinghua Center for Life Sciences, Beijing, China.

5 Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.

6 Rheumatology, Karolinska University Hospital, Stockholm, Sweden.

7 Division of Rheumatology, Department of Medicine, Hospital for Special Surgery and Weill Cornell Medicine, New York, NY, USA.

8 Biomedical Engineering & Medicine, University of Houston, Houston, TX, USA. cmohan@central.uh.edu.

Abstract

Lupus nephritis (LN) is a form of glomerulonephritis that constitutes one of the most severe organ manifestations of the autoimmune disease systemic lupus erythematosus (SLE). Most patients with SLE who develop LN do so within 5 years of an SLE diagnosis and, in many cases, LN is the presenting manifestation resulting in the diagnosis of SLE. Understanding of the genetic and pathogenetic basis of LN has improved substantially over the past few decades. Treatment of LN usually involves immunosuppressive therapy, typically with mycophenolate mofetil or cyclophosphamide and with glucocorticoids, although these treatments are not uniformly effective. Despite increased knowledge of disease pathogenesis and improved treatment options, LN remains a substantial cause of morbidity and death among patients with SLE. Within 10 years of an initial SLE diagnosis, 5-20% of patients with LN develop end-stage kidney disease, and the multiple comorbidities associated with immunosuppressive treatment, including infections, osteoporosis and cardiovascular and reproductive effects, remain a concern. Clearly, early and accurate diagnosis of LN and prompt initiation of therapy are of vital importance to improve outcomes in patients with SLE.