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Lupus Nephritis

Neena R. Gupta, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Renal disease associated with systemic lupus erythematosus (SLE)

  • American College of Rheumatology (ACR) criteria: persistent proteinuria >500 mg/day or ≥3 on dipstick and/or presen...

DIAGNOSIS

HISTORY

  • Assess for signs/symptoms of SLE.

  • Active nephritis is often accompanied by fever, peripheral edema, nausea, vomiting, headache and dizziness.

PHYSICAL EXAM

  • Hypertension, fever

  • Pleural/per...

TREATMENT

GENERAL MEASURES

  • Monitor bone density; optimize vitamin D and calcium intake, BMI, and regular exercise.

  • Low-salt diet

  • Avoid sun or ultraviolet light exposure.

MEDICATION

Note: Other than methylp...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Urine protein-to-creatinine ratio, urine microscopy, serum albumin, creatinine, antibody titers (especially anti-dsDNA), C3, C4, BP at least eve...

REFERENCES

1
Hahn BH, McMahon MA, Wilkinson A, et al. American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis. Arthritis Care Res (Hoboken). 2012 Jun;64(...

ADDITIONAL READING

  • Gasparotto M, Gatto M, Binda V, et al. Lupus nephritis: clinical presentations and outcomes in the 21st century. Rheumatology (Oxford). 2020 Dec 5;59(Suppl5):v3...

CODES

ICD10

M32.14 Glomerular disease in systemic lupus erythematosus 

SNOMED

  • 68815009 Systemic lupus erythematosus glomerulonephritis syndrome (disorder)

  • 73286009 SLE glomerulonephritis syndrome, WHO cla...

CLINICAL PEARLS

  • Early diagnosis, correct classification (based on renal biopsy), and rapid treatment improve renal survival.

  • Treat proliferative/progressive LN with a short induction course followed by...

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