Lupus nephritis natural history, complications and prognosis: Difference between revisions
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{{CMG}}; {{AE}} {{CZ}}, {{RT}} | {{CMG}}; {{AE}} {{CZ}}, {{RT}} | ||
==Overview== | ==Overview== | ||
==Natural History | ==Natural History== | ||
[[Lupus nephritis]] may damage different parts of the kidney. Class I has normal histology and does not show any evidence of disease and class V shows an extensive disease. | [[Lupus nephritis]] may damage different parts of the kidney. Class I has normal histology and does not show any evidence of disease and class V shows an extensive disease. | ||
==Complications== | |||
Possible complications include: | Possible complications include: | ||
* Interstitial nephritis | * Interstitial nephritis | ||
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* [[End stage renal disease]] | * [[End stage renal disease]] | ||
==Prognosis== | |||
* The class of lupus nephritis: [[Focal lupus nephritis]], [[minimal mesangial lupus nephritis]] and [[mesangial proliferative lupus nephritis]] have better prognosis than other classes. And, [[advanced sclerosis lupus nephritis]] carries a poor prognosis. | * The class of lupus nephritis: [[Focal lupus nephritis]], [[minimal mesangial lupus nephritis]] and [[mesangial proliferative lupus nephritis]] have better prognosis than other classes. And, [[advanced sclerosis lupus nephritis]] carries a poor prognosis. | ||
* Nephrotic syndrome carries worse prognosis. | * Nephrotic syndrome carries worse prognosis. | ||
Revision as of 18:51, 30 September 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2], Raviteja Guddeti, M.B.B.S. [3]
Overview
Natural History
Lupus nephritis may damage different parts of the kidney. Class I has normal histology and does not show any evidence of disease and class V shows an extensive disease.
Complications
Possible complications include:
- Interstitial nephritis
- Nephrotic syndrome
- Membranous glomerulonephritis
- Kidney failure - acute and chronic
- End stage renal disease
Prognosis
- The class of lupus nephritis: Focal lupus nephritis, minimal mesangial lupus nephritis and mesangial proliferative lupus nephritis have better prognosis than other classes. And, advanced sclerosis lupus nephritis carries a poor prognosis.
- Nephrotic syndrome carries worse prognosis.
- Creatinine level: Patients with elevated creatinine (>3 mg/dL) at presentation have worse outcomes.
- Patients with persistently elevated anti-dsDNA and low C3 and C4 levels have poorer outcomes.
- Renal biopsy findings showing diffuse lupus nephritis or high chronicity index suggest worse prognosis.
- Young age onset carries worse prognosis.
- Male gender have poorer outcomes than female.
- Black race have worse outcomes than other races.
- Although lupus nephritis may return in a transplanted kidney, it rarely leads to end-stage kidney disease.