SHM's Clinical Quick Talks-Lupus Nephritis

Pdf Summary

Lupus nephritis is a common complication of lupus, affecting approximately 50% of patients. It can present as acute renal failure, hypertension, lower extremity edema, or hypercoagulability. Other extra-renal manifestations, such as ulcers on the roof of the mouth or nose, alopecia, rashes, arthritis, seizures, and cardiac or pulmonary symptoms, can also help with the diagnosis.<br /><br />The suggested work-up for lupus nephritis includes a complete blood count, complete metabolic panel, inflammatory markers, complement proteins, urine analysis, antinuclear antibody (ANA) testing, extractable nuclear antigen (ENA) testing, anti-phospholipid antibody testing, and renal biopsy. These tests help to confirm the diagnosis, rule out other conditions, and classify the severity of the nephritis.<br /><br />Treatment for lupus nephritis depends on the classification of the disease. Induction therapy often involves corticosteroids and immunosuppressant medications. Additional therapies may include blood pressure management, the use of hydroxychloroquine, and the consideration of belimumab for increased renal response rates.<br /><br />It is important to note that lupus nephritis can be a presenting symptom of lupus itself. Therefore, it should be suspected in patients with new or worsening hypertension, lower extremity edema, hypercoagulability, and extra-renal manifestations. Timely diagnosis and appropriate management, including follow-up with nephrology and rheumatology, can help improve outcomes for patients with lupus nephritis.<br /><br />Overall, this article provides an overview of the epidemiology, diagnostic clues, work-up, classification, and management of lupus nephritis, highlighting the importance of recognizing and treating this condition in patients with lupus.

Asset Subtitle

Megan Schluentz, Sonam Kiwalkar

Keywords

Lupus nephritis

complication

renal failure

hypertension

edema

hypercoagulability

extra-renal manifestations

diagnosis

treatment

epidemiology