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Lupus nephritis

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Definition:

Lupus nephritis is a kidney disorder that is a complication of systemic lupus erythematosus , characterized by damage to the glomerulus and progressive loss of kidney function.

Alternative Names:

Nephritis - lupus; Lupus glomerular disease

Causes, incidence, and risk factors:

Lupus nephritis is one complication of systemic lupus erythematosus ( SLE ). It is related to the autoimmune process of lupus, where the immune system produces antibodies ( antinuclear antibody and others) against body components. Complexes of these antibodies and complement accumulate in the kidneys and result in an inflammatory response .

Lupus causes various disorders of the internal structures of the kidney, including interstitial nephritis , mesangial GN, membranous GN , membranoproliferative GN, diffuse proliferative GN, and others.

It often causes nephrotic syndrome (excessive protein excretion) and may progress rapidly to renal failure . There is progressive azotemia (the accumulation of nitrogenous waste products in the bloodstream) and urinary abnormalities including protein and blood in the urine .

Lupus nephritis affects approximately 3 out of 10,000 people. Systemic lupus erythematosus is most common in women 20-40 years old. It runs in families and is more common in blacks. It may be related to other autoimmune disorders including rheumatoid arthritis and scleroderma . It has been known to be triggered by pregnancy in some cases.

In children with SLE, about half will have some form or degree of kidney involvement.

References:

Harris ED. Budd RC, Genovese MC, Firestein GS, Sargent JS, Sledge CB. Kelley's Textbook of Rheumatology . 7th ed. St. Louis, Mo: WB Saunders; 2005.

Noble J. Textbook of Primary Care Medicine . 3rd ed. St. Louis, Mo: Mosby; 2001.

• Review Date: 9/13/2005
• Reviewed By: Robert Mushnick, M.D., Clinical Assistant Professor, SUNY Downstate Health Center, Brooklyn, NY. Review provided by VeriMed Healthcare Network.

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