Lupus nephritis
| Lupus nephritis | |
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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 |
| MeSH | D008181 |
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Lupus nephritis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Lupus nephritis On the Web |
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American Roentgen Ray Society Images of Lupus nephritis |
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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]; Ujjwal Rastogi, MBBS [3]; Raviteja Guddeti, M.B.B.S. [4]
Synonyms and keywords: Nephritis - lupus; lupus glomerular disease
Diagnosis
Laboratory Findings
Tests that may be done include:
- ANA titer.
- BUN and creatinine.
- Lupus test.
- Urinalysis.
- Urine immunoglobulin light chain
Chest X-ray
- Shows signs of fluid collection in the lungs in very severe cases.
Treatment
Medical Therapy
- 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.
- Dialysis to control symtopms of kidney failure. There are two types of dialysis, hemodialysis and peritoneal dialysis.
The drug 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.
Surgical Therapy
- A kidney transplant may be recommended. People with active lupus should not have a transplant because the condition can occur in the transplanted kidney.
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