Chapter 25
Lupus Nephritis
Matthew A. Roberts,
David J Tunnicliffe,
Matthew A. Roberts
Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
Search for more papers by this authorDavid J Tunnicliffe
Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
Search for more papers by this authorMatthew A. Roberts,
David J Tunnicliffe,
Matthew A. Roberts
Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
Search for more papers by this authorDavid J Tunnicliffe
Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
Search for more papers by this authorBook Editor(s):Jonathan C. Craig MBChB, DipCH, MMed(Clin Epi), PhD, FAHMS,
Donald A. Molony MD,
Giovanni F.M. Strippoli MD, PhD, MPH, MM (Epi),
Jonathan C. Craig MBChB, DipCH, MMed(Clin Epi), PhD, FAHMS
Matthew Flinders Distinguished Professor Vice President and Executive Dean
College of Medicine and Public Health, Flinders University, Adelaide, Australia
Search for more papers by this authorDonald A. Molony MD
Professor of Medicine Distinguished Teaching Professor of the University of Texas System
Division of Renal Diseases and Hypertension AND Center for Clinical Research and Evidence-based Medicine, McGovern Medical School University of Texas, Houston, TX, USA
Search for more papers by this authorGiovanni F.M. Strippoli MD, PhD, MPH, MM (Epi)
Professor of Nephrology Adjunct Professor of Epidemiology
Department of Emergency and Organ Transplantation – University of Bari, Bari, Italy
School of Public Health, University of Sydney, Sydney, NSW, Australia
Search for more papers by this authorFirst published: 18 November 2022
Summary
Lupus nephritis is an important manifestation of the multisystem autoimmune disease systemic lupus erythematosus (SLE) with clinical features ranging from asymptomatic abnormalities on urine microscopy, to the nephrotic syndrome, to rapid loss of kidney function. In SLE there is disordered immune regulation leading to loss of self-tolerance, production of autoantibodies, and formation of immune complexes. The renal disorder criteria in both classifications are based on urinary findings: a measure of proteinuria and the presence of red blood cells or casts in the urine. Lupus nephritis is a classic autoimmune condition that requires giving enough immunosuppression to treat the disease adequately, but not enough to cause harm. As in other forms of glomerulonephritis, non-immunosuppressive therapy for lupus nephritis is intended to reduce proteinuria and control hypertension. Most patients with lupus nephritis are women of child bearing age and pregnancy should discuss early in their course to determine the management to be implemented before conception.
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