Lupus nephritis natural history, complications and prognosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Lupus nephritis}} | {{Lupus nephritis}} | ||
{{CMG}}; {{AE}} [[User:Okamal|Omer Kamal, M.D.]][[Mailto:okamal@bidmc.harvard.edu|[2]]] {{CZ}}, {{RT}} | {{CMG}}; {{AE}} [[User:Okamal|Omer Kamal, M.D.]][[Mailto:okamal@bidmc.harvard.edu| [2]]] {{CZ}}, {{RT}} | ||
==Overview== | ==Overview== | ||
Common complications of [[Lupus nephritis]] include microscopic [[hematuria]], [[nephrotic syndrome]], celluar casts, elevated creatnine and destruction of more than 50% of glomeruli. | |||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
===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. | ||
*The symptoms of Lupus | *The symptoms of [[Lupus nephritis]] usually develop in one half of the patients with [[SLE]] and start with symptoms such as [[proteinuria]]. | ||
*The symptoms of | *The symptoms of [[Lupus nephritis]] typically develop within three years after having [[SLE]].<ref name="pmid27821390">{{cite journal |vauthors=Almaani S, Meara A, Rovin BH |title=Update on Lupus Nephritis |journal=Clin J Am Soc Nephrol |volume=12 |issue=5 |pages=825–835 |date=May 2017 |pmid=27821390 |pmc=5477208 |doi=10.2215/CJN.05780616 |url=}}</ref> | ||
*If left untreated, | *If left untreated, thirty percent of patients with [[SLE]] may progress to develop [[hematuria]], [[nephrotic syndrome]], and [[hypertension]]. | ||
===Complications=== | ===Complications=== | ||
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* [[Kidney failure]] - acute and chronic | * [[Kidney failure]] - acute and chronic | ||
* [[End stage renal disease]] | * [[End stage renal disease]] | ||
* [[Hypertension]] | |||
===Prognosis=== | ===Prognosis=== | ||
Revision as of 17:40, 19 July 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omer Kamal, M.D.[[2]] Cafer Zorkun, M.D., Ph.D. [2], Raviteja Guddeti, M.B.B.S. [3]
Overview
Common complications of Lupus nephritis include microscopic hematuria, nephrotic syndrome, celluar casts, elevated creatnine and destruction of more than 50% of glomeruli.
Natural History, Complications, and Prognosis
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.
- The symptoms of Lupus nephritis usually develop in one half of the patients with SLE and start with symptoms such as proteinuria.
- The symptoms of Lupus nephritis typically develop within three years after having SLE.[1]
- If left untreated, thirty percent of patients with SLE may progress to develop hematuria, nephrotic syndrome, and hypertension.
Complications
Possible complications include:
- Interstitial nephritis
- Nephrotic syndrome
- Membranous glomerulonephritis
- Kidney failure - acute and chronic
- End stage renal disease
- Hypertension
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.
- Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
- Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
- The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
- [Subtype of disease/malignancy] is associated with the most favorable prognosis.
- The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
References
- ↑ Almaani S, Meara A, Rovin BH (May 2017). "Update on Lupus Nephritis". Clin J Am Soc Nephrol. 12 (5): 825–835. doi:10.2215/CJN.05780616. PMC 5477208. PMID 27821390.