Materiały źródłowe

• #1 Lupus Nephritis: What Is It, Causes, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/21809-lupus-nephritis

  Lupus nephritis is kidney inflammation due to lupus, an autoimmune disease. About half of adults and 80% of children with lupus will develop lupus nephritis. […] Lupus nephritis is inflammation and damage in your kidneys due to systemic lupus erythematosus (SLE). SLE is the most common form of lupus. Lupus is an autoimmune disease that triggers your immune system to attack your tissues. […] In lupus nephritis, your body attacks your kidney, which leads to inflammation and abnormal kidney function. Long-term inflammation leads to scarring and permanent kidney damage. […] Only adults and children with lupus can develop lupus nephritis. […] About 50% of adults with lupus will develop lupus nephritis. About 80% of children with lupus will develop this kidney condition.

• #2 Lupus & Kidney Disease (Lupus Nephritis) – NIDDK

  https://www.niddk.nih.gov/health-information/kidney-disease/lupus-nephritis

  Lupus nephritis is a type of kidney disease caused by systemic lupus erythematosus (SLE or lupus). […] Kidney damage is one of the more common health problems caused by lupus. […] African Americans, Hispanics/Latinos, and Asian Americans are more likely to develop lupus nephritis than Caucasians. […] Lupus nephritis is more common in men than in women. […] A kidney biopsy can confirm a diagnosis of lupus nephritis. […] Health care professionals treat lupus nephritis with medicines that suppress your immune system so it stops attacking and damaging your kidneys. […] Between 10 to 30 percent of people who have lupus nephritis develop kidney failure. […] The most severe form of lupus nephritis, called diffuse proliferative nephritis, can cause scars to form in the kidneys. […] People who have lupus nephritis are at a high risk for cancer, primarily B-cell lymphoma.

• #3 Lupus Nephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499817/

  The pathogenesis of lupus nephritis involves a combination of genetic, environmental, and immune system factors. The condition is primarily driven by a type III hypersensitivity reaction, which leads to the formation of immune complexes. Anti-double-stranded deoxyribonucleic acid (anti-dsDNA) antibodies bind to DNA, which forms anti-dsDNA immune complexes. These immune complexes deposit in the mesangium, subendothelial, or subepithelial spaces near the glomerular basement membrane, triggering an inflammatory response. This activates the complement pathway, resulting in the influx of neutrophils and other inflammatory cells, which contribute to the development of lupus nephritis. […] As with many other autoimmune diseases, genetic predilection has a significant role in the development of SLE and lupus nephritis. The loss of self-tolerance is considered a polygenic phenomenon, although this is incompletely understood. Over 50 genetic polymorphisms have been linked to the development of lupus nephritis, including those involving platelet-derived growth factor receptor-alpha, apolipoprotein L1, and hyaluronan synthase 2. Human leukocytic antigen (HLA) alleles are also associated with lupus nephritis. Specifically, HLA-DR3 and HLA-DR15 increase the risk of lupus nephritis, particularly in patients of European descent, whereas HLA-DR4 and HLA-DR11 appear to offer protective effects.

• #4 Lupus Nephritis from Pathogenesis to New Therapies: An Update

  https://www.mdpi.com/1422-0067/25/16/8981

  Lupus Nephritis (LN) represents one of the most severe and frequent complications of Systemic Lupus Erythematosus (SLE) and a major risk factor for morbidity and mortality, potentially leading to end-stage renal disease (ESRD). […] Etiopathogenetic mechanisms are complex and involve multiple inflammatory pathways and cell types, far exceeding immune complex (IC) deposition. Significant progress has been made over the last years in understanding the role of innate immunity cells, such as neutrophils, monocytes and dendritic cells (DC) and the interaction between them and kidney resident cells. […] The pathogenesis of LN is complex and multi-factorial. It involves a variety of extra- and intra-renal pathogenic mechanisms, resulting from genetic predisposition as well as environmental and hormonal factors.

• #5 Lupus Nephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499817/

  The pathogenesis of lupus nephritis involves a combination of genetic, environmental, and immune system factors. The condition is primarily driven by a type III hypersensitivity reaction, which leads to the formation of immune complexes. Anti-double-stranded deoxyribonucleic acid (anti-dsDNA) antibodies bind to DNA, which forms anti-dsDNA immune complexes. These immune complexes deposit in the mesangium, subendothelial, or subepithelial spaces near the glomerular basement membrane, triggering an inflammatory response. This activates the complement pathway, resulting in the influx of neutrophils and other inflammatory cells, which contribute to the development of lupus nephritis. […] As with many other autoimmune diseases, genetic predilection has a significant role in the development of SLE and lupus nephritis. The loss of self-tolerance is considered a polygenic phenomenon, although this is incompletely understood. Over 50 genetic polymorphisms have been linked to the development of lupus nephritis, including those involving platelet-derived growth factor receptor-alpha, apolipoprotein L1, and hyaluronan synthase 2. Human leukocytic antigen (HLA) alleles are also associated with lupus nephritis. Specifically, HLA-DR3 and HLA-DR15 increase the risk of lupus nephritis, particularly in patients of European descent, whereas HLA-DR4 and HLA-DR11 appear to offer protective effects.

• #6 Lupus nephritis – Wikipedia

  https://en.wikipedia.org/wiki/Lupus_nephritis

  Lupus nephritis is an inflammation of the kidneys caused by systemic lupus erythematosus (SLE) and childhood-onset systemic lupus erythematosus which is a more severe form of SLE that develops in children up to 18 years old; both are autoimmune diseases. […] Lupus nephritis develops through a mix of genetic, environmental, and immune system influences. […] It is mainly caused by a type III hypersensitivity reaction, where antibodies against double-stranded DNA (anti-dsDNA) form immune complexes with DNA. […] The pathophysiology of lupus nephritis has autoimmunity contributing significantly. Autoantibodies direct themselves against nuclear elements. The characteristics of nephritogenic autoantibodies (lupus nephritis) are antigen specificity directed at nucleosome, high affinity autoantibodies form intravascular immune complexes, and autoantibodies of certain isotypes activate complement.

• #7 Lupus Nephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499817/

  The pathogenesis of lupus nephritis involves a combination of genetic, environmental, and immune system factors. The condition is primarily driven by a type III hypersensitivity reaction, which leads to the formation of immune complexes. Anti-double-stranded deoxyribonucleic acid (anti-dsDNA) antibodies bind to DNA, which forms anti-dsDNA immune complexes. These immune complexes deposit in the mesangium, subendothelial, or subepithelial spaces near the glomerular basement membrane, triggering an inflammatory response. This activates the complement pathway, resulting in the influx of neutrophils and other inflammatory cells, which contribute to the development of lupus nephritis. […] As with many other autoimmune diseases, genetic predilection has a significant role in the development of SLE and lupus nephritis. The loss of self-tolerance is considered a polygenic phenomenon, although this is incompletely understood. Over 50 genetic polymorphisms have been linked to the development of lupus nephritis, including those involving platelet-derived growth factor receptor-alpha, apolipoprotein L1, and hyaluronan synthase 2. Human leukocytic antigen (HLA) alleles are also associated with lupus nephritis. Specifically, HLA-DR3 and HLA-DR15 increase the risk of lupus nephritis, particularly in patients of European descent, whereas HLA-DR4 and HLA-DR11 appear to offer protective effects.

• #8 Lupus Nephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499817/

  The pathogenesis of lupus nephritis involves a combination of genetic, environmental, and immune system factors. The condition is primarily driven by a type III hypersensitivity reaction, which leads to the formation of immune complexes. Anti-double-stranded deoxyribonucleic acid (anti-dsDNA) antibodies bind to DNA, which forms anti-dsDNA immune complexes. These immune complexes deposit in the mesangium, subendothelial, or subepithelial spaces near the glomerular basement membrane, triggering an inflammatory response. This activates the complement pathway, resulting in the influx of neutrophils and other inflammatory cells, which contribute to the development of lupus nephritis. […] As with many other autoimmune diseases, genetic predilection has a significant role in the development of SLE and lupus nephritis. The loss of self-tolerance is considered a polygenic phenomenon, although this is incompletely understood. Over 50 genetic polymorphisms have been linked to the development of lupus nephritis, including those involving platelet-derived growth factor receptor-alpha, apolipoprotein L1, and hyaluronan synthase 2. Human leukocytic antigen (HLA) alleles are also associated with lupus nephritis. Specifically, HLA-DR3 and HLA-DR15 increase the risk of lupus nephritis, particularly in patients of European descent, whereas HLA-DR4 and HLA-DR11 appear to offer protective effects.

• #9 Lupus nephritis | Altru Health System

  https://www.altru.org/health-library/conditions/lupus-nephritis

  Lupus nephritis is a problem that occurs often in people who have systemic lupus erythematosus, also called lupus. […] Lupus causes the immune system to make proteins called autoantibodies. These proteins attack tissues and organs in the body, including the kidneys. […] Lupus nephritis occurs when lupus autoantibodies affect parts of the kidneys that filter out waste. This causes swelling and irritation of the kidneys, called inflammation. It might lead to blood in the urine, protein in the urine, high blood pressure, kidneys that don’t work well or even kidney failure. […] As many as half of adults with systemic lupus get lupus nephritis. Systemic lupus causes the body’s immune system to damage the kidneys. Then the kidneys can’t filter out waste as they should.

• #10 Lupus nephritis: Causes, Symptoms And Treatment

  https://www.netmeds.com/health-library/post/lupus-nephritis-causes-symptoms-and-treatment?srsltid=AfmBOoqIskps79Qvf4xsV58hi8UClFJ4bShJ0Lq6QEku2hhvAjFDyrkL

  Lupus nephritis is a common associated condition that is primarily noticed in people suffering from lupus erythematosus causing inflammation of the kidneys. […] Lupus nephritis chiefly occurs when the autoantibodies arising due to lupus affect structures in the kidneys that are employed to filter out waste from the body. This induces inflammation of the kidneys and may lead to blood and protein in the urine, high blood pressure, imbalance of salts, acids and minerals in the body fluids, hormonal imbalance steering towards degraded kidney function, kidney failure and even end-stage renal disease. […] As many as half the population with systemic lupus erythematosus develops lupus nephritis with time. This condition causes the immune system proteins to harm the kidneys, damaging their ability to filter out waste. Long-term inflammation of the kidneys leads to scarring and permanent kidney damage. […] Certain causative factors that increase the risk of Lupus nephritis: […] A person who has a family history of the disease or any other autoimmune disease is at a higher risk of Lupus nephritis.

• #11 Lupus Nephritis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/330369-overview

  Lupus nephritis is clinically evident in 50-60% of patients with systemic lupus erythematosus (SLE), and it is histologically evident in most SLE patients, even those without clinical manifestations of kidney disease. […] As with many autoimmune disorders, evidence suggests that genetic predisposition plays an important role in the development of both SLE and lupus nephritis. Multiple genes, many of which are not yet identified, mediate this genetic predisposition. […] SLE is more common in first-degree relatives of patients with SLE (familial prevalence, 10-12%). Concordance rates are higher in monozygotic twins (24-58%) than in dizygotic twins (2-5%), supporting an important role for genetics in the development of SLE. However, the concordance rate in monozygotic twins is not 100%, suggesting that environmental factors trigger development of clinical disease.

• #12 Lupus Nephritis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/330369-overview

  Lupus nephritis is clinically evident in 50-60% of patients with systemic lupus erythematosus (SLE), and it is histologically evident in most SLE patients, even those without clinical manifestations of kidney disease. […] As with many autoimmune disorders, evidence suggests that genetic predisposition plays an important role in the development of both SLE and lupus nephritis. Multiple genes, many of which are not yet identified, mediate this genetic predisposition. […] SLE is more common in first-degree relatives of patients with SLE (familial prevalence, 10-12%). Concordance rates are higher in monozygotic twins (24-58%) than in dizygotic twins (2-5%), supporting an important role for genetics in the development of SLE. However, the concordance rate in monozygotic twins is not 100%, suggesting that environmental factors trigger development of clinical disease.

• #13 Lupus Nephritis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/330369-overview

  Human leukocyte antigen (HLA) class II genes include the following: HLA-DR2 and HLA-DR3 are associated with SLE; HLA-DR4 is associated with a lower prevalence of SLE and appears to be protective. […] C1Q, C1R, and C1S deficiencies are associated with SLE, lupus nephritis, and production of anti-dsDNA. […] The initial autoantibody response appears to be directed against the nucleosome, which arises from apoptotic cells. […] Patients with SLE have poor clearance mechanisms for cellular debris. Nuclear debris from apoptotic cells induces plasmacytoid dendritic cells to produce interferon-, which is a potent inducer of the immune system and autoimmunity. […] Autoreactive B lymphocytes, which are normally inactive, become active in SLE because of a malfunction of normal homeostatic mechanisms, resulting in escape from tolerance. This leads to the production of autoantibodies.

• #14

  https://journals.lww.com/cjasn/fulltext/2017/05000/update_on_lupus_nephritis.16.aspx

  The APOL1 gene, which has been implicated in the development of ESRD in black patients, has also been associated with progression and development of ESRD in the LN population. […] LN is a major risk factor for morbidity and mortality in SLE and 10% of patients with LN will develop ESRD. […] The risk of ESRD is higher in certain subsets of LN. […] Importantly, 10-year survival improves from 46% to 95% if disease remission can be achieved. […] SLE arises in individuals with an appropriate genetic background exposed to certain environmental triggers. […] Several genes have been associated with SLE susceptibility, most prominently in the human HLA loci. […] The mechanisms of HLA-based disease susceptibility and protection remain unknown. […] The limitations of these and other genetic association studies are the relatively small numbers of affected patients available for analysis, and the limited racial and ethnic diversity of the study cohorts, which to date have mainly focused on white and Asian patients.

• #15 Lupus Nephritis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/330369-overview

  Human leukocyte antigen (HLA) class II genes include the following: HLA-DR2 and HLA-DR3 are associated with SLE; HLA-DR4 is associated with a lower prevalence of SLE and appears to be protective. […] C1Q, C1R, and C1S deficiencies are associated with SLE, lupus nephritis, and production of anti-dsDNA. […] The initial autoantibody response appears to be directed against the nucleosome, which arises from apoptotic cells. […] Patients with SLE have poor clearance mechanisms for cellular debris. Nuclear debris from apoptotic cells induces plasmacytoid dendritic cells to produce interferon-, which is a potent inducer of the immune system and autoimmunity. […] Autoreactive B lymphocytes, which are normally inactive, become active in SLE because of a malfunction of normal homeostatic mechanisms, resulting in escape from tolerance. This leads to the production of autoantibodies.

• #16 Lupus Nephritis Risk Factors and Biomarkers: An Update

  https://www.mdpi.com/1422-0067/24/19/14526

  Monogenic loss in the function of deoxyribonuclease (DNase1, DNASE1L3) and/or of ribonucleases (RNASEH2A/B/C) that digest cell-free RNA/DNA causes SLE with anti-dsDNA/RNA Abs development and a high rate of LN. […] Monogenetic complement deficiencies (C1q but also C1r, C1s, C2, and C3) or copy number variations (CNVs) in C4 alter the initiation of the classical complement pathway and, in turn, are causal for SLE/LN development. […] One of the most important genetic risk factors associated with SLE is related to the human leukocyte antigen (HLA) region with HLA-DR3 and -DR15 retrieved as risk factors for LN, whereas HLA-DR4 and -DR11 are protective.

• #17 Lupus Nephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499817/

  The pathogenesis of lupus nephritis involves a combination of genetic, environmental, and immune system factors. The condition is primarily driven by a type III hypersensitivity reaction, which leads to the formation of immune complexes. Anti-double-stranded deoxyribonucleic acid (anti-dsDNA) antibodies bind to DNA, which forms anti-dsDNA immune complexes. These immune complexes deposit in the mesangium, subendothelial, or subepithelial spaces near the glomerular basement membrane, triggering an inflammatory response. This activates the complement pathway, resulting in the influx of neutrophils and other inflammatory cells, which contribute to the development of lupus nephritis. […] As with many other autoimmune diseases, genetic predilection has a significant role in the development of SLE and lupus nephritis. The loss of self-tolerance is considered a polygenic phenomenon, although this is incompletely understood. Over 50 genetic polymorphisms have been linked to the development of lupus nephritis, including those involving platelet-derived growth factor receptor-alpha, apolipoprotein L1, and hyaluronan synthase 2. Human leukocytic antigen (HLA) alleles are also associated with lupus nephritis. Specifically, HLA-DR3 and HLA-DR15 increase the risk of lupus nephritis, particularly in patients of European descent, whereas HLA-DR4 and HLA-DR11 appear to offer protective effects.

• #18 Lupus nephritis – Symptoms, treatment and complications – American Kidney Fund (AKF)

  https://www.kidneyfund.org/all-about-kidneys/other-kidney-diseases/lupus-nephritis-symptoms-treatment-and-complications

  Lupus is an autoimmune disease. Autoimmune diseases cause your immune system to attack your healthy cells. Lupus can affect many parts of the body. When your immune system attacks your kidneys, it is called lupus nephritis. The most severe kind of lupus nephritis is proliferative nephritis, which can cause permanent damage to your kidneys. Many experts believe the cause of lupus is a combination of genetic and environmental factors. […] People who have a family member with lupus nephritis are also at a higher risk. If you have a family member with lupus, you should share this information with your doctor and ask if you need to be tested. Many experts believe the cause of lupus is a combination of genetic and environmental factors. For example, having the APOL-1 gene can increase your risk of developing kidney disease and lupus nephritis.

• #19 Lupus Nephritis: Symptoms, Causes, Treatments, and More

  https://resources.healthgrades.com/right-care/lupus/lupus-nephritis

  Lupus nephritis refers to kidney disease caused by systemic lupus erythematosus (SLE). […] Researchers do not know what causes lupus nephritis. […] SLE is an autoimmune disease. This means your immune system attacks its healthy cells. Lupus nephritis is when SLE damages the kidneys. […] Up to 60% of people with SLE will develop lupus nephritis, according to the Lupus Foundation of America. […] Researchers have identified variants in the APOL1 gene that may play a role in the risk of developing end-stage kidney disease with SLE, particularly in African Americans. […] More research is needed to better understand the causes of lupus nephritis. […] Researchers do not know the exact cause of lupus nephritis, so preventing the condition may not be possible.

• #20

  https://journals.lww.com/cjasn/fulltext/2017/05000/update_on_lupus_nephritis.16.aspx

  The APOL1 gene, which has been implicated in the development of ESRD in black patients, has also been associated with progression and development of ESRD in the LN population. […] LN is a major risk factor for morbidity and mortality in SLE and 10% of patients with LN will develop ESRD. […] The risk of ESRD is higher in certain subsets of LN. […] Importantly, 10-year survival improves from 46% to 95% if disease remission can be achieved. […] SLE arises in individuals with an appropriate genetic background exposed to certain environmental triggers. […] Several genes have been associated with SLE susceptibility, most prominently in the human HLA loci. […] The mechanisms of HLA-based disease susceptibility and protection remain unknown. […] The limitations of these and other genetic association studies are the relatively small numbers of affected patients available for analysis, and the limited racial and ethnic diversity of the study cohorts, which to date have mainly focused on white and Asian patients.

• #21 Lupus Nephritis Risk Factors and Biomarkers: An Update

  https://www.mdpi.com/1422-0067/24/19/14526

  Monogenic loss in the function of deoxyribonuclease (DNase1, DNASE1L3) and/or of ribonucleases (RNASEH2A/B/C) that digest cell-free RNA/DNA causes SLE with anti-dsDNA/RNA Abs development and a high rate of LN. […] Monogenetic complement deficiencies (C1q but also C1r, C1s, C2, and C3) or copy number variations (CNVs) in C4 alter the initiation of the classical complement pathway and, in turn, are causal for SLE/LN development. […] One of the most important genetic risk factors associated with SLE is related to the human leukocyte antigen (HLA) region with HLA-DR3 and -DR15 retrieved as risk factors for LN, whereas HLA-DR4 and -DR11 are protective.

• #22 Lupus Nephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499817/

  Several gene variations contribute to the development of lupus nephritis, as mentioned below. […] Up to 80% of patients with SLE exhibit sensitivity to UV light, with skin exposure often triggering symptoms and lupus flares. UV light promotes neutrophilic infiltration in the skin. […] Dysregulation of the gut microbiome may contribute to SLE, as increased intestinal membrane permeability can allow bacterial translocation into the systemic circulation. […] Viral infections, particularly Epstein-Barr virus, parvovirus B19, and human endogenous retroviruses, have been associated with SLE flares and lupus nephritis. […] Immune system dysregulation in SLE has been well-understood for many decades. Lupus nephritis is a type III hypersensitivity reaction that results from the formation of immune complexes. Autoimmunity has a crucial role in the development of lupus nephritis, leading to the production of autoantibodies directed against nuclear elements.

• #23 Lupus Nephritis from Pathogenesis to New Therapies: An Update

  https://www.mdpi.com/1422-0067/25/16/8981

  The role of ultraviolet beams (UVB) in modulating the expression of disease is well known. […] Interestingly, UVB appears to stimulate neutrophil migration also to the kidney in an interleukin (IL)-17A-dependent manner, creating a “kidney-skin” axis. […] Air pollution has been recently drawing attention. […] The role of viral infections in triggering SLE and modulating the risk of LN is well known, including recent reports of de novo LN following SARS-CoV-2 infection. […] An association between dysbiosis and microbial antigens with LN has been emerging. […] The role of food in modulating inflammation is an expanding area of research. […] Vitamin D deficiency appears to be involved both in the mechanism of immune dysregulation of SLE and in the pathogenesis of LN. […] Overall vitamin D deficiency appears to be involved both in the mechanism of immune dysregulation of SLE and in the pathogenesis of LN.

• #24 Lupus Nephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499817/

  Several gene variations contribute to the development of lupus nephritis, as mentioned below. […] Up to 80% of patients with SLE exhibit sensitivity to UV light, with skin exposure often triggering symptoms and lupus flares. UV light promotes neutrophilic infiltration in the skin. […] Dysregulation of the gut microbiome may contribute to SLE, as increased intestinal membrane permeability can allow bacterial translocation into the systemic circulation. […] Viral infections, particularly Epstein-Barr virus, parvovirus B19, and human endogenous retroviruses, have been associated with SLE flares and lupus nephritis. […] Immune system dysregulation in SLE has been well-understood for many decades. Lupus nephritis is a type III hypersensitivity reaction that results from the formation of immune complexes. Autoimmunity has a crucial role in the development of lupus nephritis, leading to the production of autoantibodies directed against nuclear elements.

• #25 Lupus Nephritis from Pathogenesis to New Therapies: An Update

  https://www.mdpi.com/1422-0067/25/16/8981

  The role of ultraviolet beams (UVB) in modulating the expression of disease is well known. […] Interestingly, UVB appears to stimulate neutrophil migration also to the kidney in an interleukin (IL)-17A-dependent manner, creating a “kidney-skin” axis. […] Air pollution has been recently drawing attention. […] The role of viral infections in triggering SLE and modulating the risk of LN is well known, including recent reports of de novo LN following SARS-CoV-2 infection. […] An association between dysbiosis and microbial antigens with LN has been emerging. […] The role of food in modulating inflammation is an expanding area of research. […] Vitamin D deficiency appears to be involved both in the mechanism of immune dysregulation of SLE and in the pathogenesis of LN. […] Overall vitamin D deficiency appears to be involved both in the mechanism of immune dysregulation of SLE and in the pathogenesis of LN.

• #26 Lupus Nephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499817/

  Several gene variations contribute to the development of lupus nephritis, as mentioned below. […] Up to 80% of patients with SLE exhibit sensitivity to UV light, with skin exposure often triggering symptoms and lupus flares. UV light promotes neutrophilic infiltration in the skin. […] Dysregulation of the gut microbiome may contribute to SLE, as increased intestinal membrane permeability can allow bacterial translocation into the systemic circulation. […] Viral infections, particularly Epstein-Barr virus, parvovirus B19, and human endogenous retroviruses, have been associated with SLE flares and lupus nephritis. […] Immune system dysregulation in SLE has been well-understood for many decades. Lupus nephritis is a type III hypersensitivity reaction that results from the formation of immune complexes. Autoimmunity has a crucial role in the development of lupus nephritis, leading to the production of autoantibodies directed against nuclear elements.

• #27 Lupus Nephritis from Pathogenesis to New Therapies: An Update

  https://www.mdpi.com/1422-0067/25/16/8981

  The role of ultraviolet beams (UVB) in modulating the expression of disease is well known. […] Interestingly, UVB appears to stimulate neutrophil migration also to the kidney in an interleukin (IL)-17A-dependent manner, creating a “kidney-skin” axis. […] Air pollution has been recently drawing attention. […] The role of viral infections in triggering SLE and modulating the risk of LN is well known, including recent reports of de novo LN following SARS-CoV-2 infection. […] An association between dysbiosis and microbial antigens with LN has been emerging. […] The role of food in modulating inflammation is an expanding area of research. […] Vitamin D deficiency appears to be involved both in the mechanism of immune dysregulation of SLE and in the pathogenesis of LN. […] Overall vitamin D deficiency appears to be involved both in the mechanism of immune dysregulation of SLE and in the pathogenesis of LN.

• #28 Lupus Nephritis from Pathogenesis to New Therapies: An Update

  https://www.mdpi.com/1422-0067/25/16/8981

  The role of ultraviolet beams (UVB) in modulating the expression of disease is well known. […] Interestingly, UVB appears to stimulate neutrophil migration also to the kidney in an interleukin (IL)-17A-dependent manner, creating a “kidney-skin” axis. […] Air pollution has been recently drawing attention. […] The role of viral infections in triggering SLE and modulating the risk of LN is well known, including recent reports of de novo LN following SARS-CoV-2 infection. […] An association between dysbiosis and microbial antigens with LN has been emerging. […] The role of food in modulating inflammation is an expanding area of research. […] Vitamin D deficiency appears to be involved both in the mechanism of immune dysregulation of SLE and in the pathogenesis of LN. […] Overall vitamin D deficiency appears to be involved both in the mechanism of immune dysregulation of SLE and in the pathogenesis of LN.

• #29 Pathology Outlines – Systemic lupus erythematosus

  https://www.pathologyoutlines.com/topic/kidneysle.html

  Lupus nephritis is primarily caused by type 3 (immune complex) hypersensitivity reaction. […] Hydralazine can unmask and aggravate incipient lupus; other most common medications implicated in drug induced lupus are procainamide, isoniazid, minocycline and TNF inhibitors.

• #30 What Are the Causes and Risk Factors of Lupus Nephritis?

  https://www.icliniq.com/articles/kidney-and-urologic-diseases/lupus-nephritis-causes-and-risk-factors

  Aside from genetics, did you know that things like infections, medications, and stress can make lupus worse? These environmental factors can influence whether or not you develop Lupus nephritis. […] The hormone estrogen, especially, can make lupus worse. That is why women in their childbearing years are most likely to experience Lupus nephritis. […] Your lifestyle choices can affect how Lupus affects your kidneys. Things like smoking, lack of exercise, and eating poorly can make the condition worse. […] Many factors play a role in the development of lupus nephritis, like genetics, hormones, stress, and how you live your life.

• #31 What is Lupus Nephritis? Treatment and Overview | HSS

  https://www.hss.edu/conditions_lupus-nephritis-what-you-need-to-know-about-lupus-kidney-disease.asp

  For reasons that are not yet fully understood, women develop lupus far more frequently than do men (at a ratio of 9:1) and women of African, Asian and Hispanic descent are at greater risk than their Caucasian counterparts, which suggests a genetic cause. […] Moreover, lupus nephritis usually develops in people with more severe forms of lupus. […] In the case of classes III and IV, the biopsy will also indicate the proportion of glomeruli with inflammation (active) and with scar tissue (sclerotic). […] If a person is found to have Class VI disease, or advanced sclerosing lupus nephritis, the kidney contains only scar tissue without active inflammation, and therefore aggressive treatment with immunosuppressive drugs is not indicated. […] People with the more severe forms of lupus nephritis, classes III, IV and V (with nephrotic proteinuria), need to be started on an aggressive course of treatment that is also referred to as induction therapy, since the goal is to induce a remission of the inflammation and related symptoms. […] The duration of induction therapy can range from three months to one year. […] Unfortunately, people who are successfully treated for lupus nephritis remain at risk of recurrence for the condition.

• #32 What Are the Causes and Risk Factors of Lupus Nephritis?

  https://www.icliniq.com/articles/kidney-and-urologic-diseases/lupus-nephritis-causes-and-risk-factors

  Aside from genetics, did you know that things like infections, medications, and stress can make lupus worse? These environmental factors can influence whether or not you develop Lupus nephritis. […] The hormone estrogen, especially, can make lupus worse. That is why women in their childbearing years are most likely to experience Lupus nephritis. […] Your lifestyle choices can affect how Lupus affects your kidneys. Things like smoking, lack of exercise, and eating poorly can make the condition worse. […] Many factors play a role in the development of lupus nephritis, like genetics, hormones, stress, and how you live your life.

• #33 Lupus & Kidney Disease (Lupus Nephritis) – NIDDK

  https://www.niddk.nih.gov/health-information/kidney-disease/lupus-nephritis

  Lupus nephritis is a type of kidney disease caused by systemic lupus erythematosus (SLE or lupus). […] Kidney damage is one of the more common health problems caused by lupus. […] African Americans, Hispanics/Latinos, and Asian Americans are more likely to develop lupus nephritis than Caucasians. […] Lupus nephritis is more common in men than in women. […] A kidney biopsy can confirm a diagnosis of lupus nephritis. […] Health care professionals treat lupus nephritis with medicines that suppress your immune system so it stops attacking and damaging your kidneys. […] Between 10 to 30 percent of people who have lupus nephritis develop kidney failure. […] The most severe form of lupus nephritis, called diffuse proliferative nephritis, can cause scars to form in the kidneys. […] People who have lupus nephritis are at a high risk for cancer, primarily B-cell lymphoma.

• #34 What Are the Causes and Risk Factors of Lupus Nephritis?

  https://www.icliniq.com/articles/kidney-and-urologic-diseases/lupus-nephritis-causes-and-risk-factors

  In lupus nephritis, those autoantibodies attack the kidneys, causing inflammation and damage. This makes it harder for the kidneys to filter out waste, leading to issues like high blood pressure, blood in the urine, and swelling in the legs or ankles. […] The gender plays a significant role in the risk of lupus. Women are indeed much more likely than men to develop lupus, with women being about nine to ten times more likely to get it. But when it comes to lupus nephritis, men have a higher chance of developing kidney issues related to lupus. […] If someone in your family has lupus, especially a parent or sibling, you may be at higher risk. Having a family history of lupus makes you more likely to develop the condition yourself, which is why it is considered a significant risk factor for lupus nephritis.

• #35 Lupus Nephritis: Causes, Symptoms & Effective Treatments

  https://www.truemeds.in/diseases/kidney/lupus-nephritis-175

  Hormonal factors: SLE and lupus nephritis are more common in women, particularly during their reproductive years. […] Immune complex deposition: In lupus nephritis, immune complexes (combinations of autoantibodies and their target antigens) can accumulate in the kidneys, causing inflammation and damage to the glomeruli. This process can lead to impaired kidney function and the development of various symptoms associated with lupus nephritis.

• #36 Lupus Nephritis: Diagnosis, Symptoms, Treatments

  https://www.webmd.com/lupus/lupus-nephritis

  But medications with estrogen, like birth control pills and hormone replacement therapy, dont seem to raise the risk of lupus. […] It can be hard to figure out exactly which things around you can cause lupus. […] These include: […] Scientists arent yet sure what accounts for these differences, but they continue to study the subject.

• #37 Lupus Nephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499817/

  Several gene variations contribute to the development of lupus nephritis, as mentioned below. […] Up to 80% of patients with SLE exhibit sensitivity to UV light, with skin exposure often triggering symptoms and lupus flares. UV light promotes neutrophilic infiltration in the skin. […] Dysregulation of the gut microbiome may contribute to SLE, as increased intestinal membrane permeability can allow bacterial translocation into the systemic circulation. […] Viral infections, particularly Epstein-Barr virus, parvovirus B19, and human endogenous retroviruses, have been associated with SLE flares and lupus nephritis. […] Immune system dysregulation in SLE has been well-understood for many decades. Lupus nephritis is a type III hypersensitivity reaction that results from the formation of immune complexes. Autoimmunity has a crucial role in the development of lupus nephritis, leading to the production of autoantibodies directed against nuclear elements.

• #38 Lupus Nephritis | Diagnosis & Disease Information

  https://www.rheumatologyadvisor.com/ddi/lupus-nephritis/

  Lupus nephritis is one of the more common and severe manifestations of systemic lupus erythematosus (SLE). […] The etiology and pathophysiology of SLE and lupus nephritis are not completely understood. Lupus nephritis can occur as a complication of systemic lupus erythematosus when the immune system loses the mechanisms that normally assure the immune tolerance of nuclear autoantigens. […] The loss of tolerance can result in excessive T helper cell and B cell activation that leads to the production of autoantibodies and complement activation that causes inflammation. When inflammation occurs in the kidneys, it results in lupus nephritis. […] Risk factors associated with developing lupus nephritis include the following: African American, Asian, Pacific Islander, or Hispanic race/ethnicity; Juvenile-onset SLE; and Male sex.

• #39 Lupus Nephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499817/

  The pathogenesis of lupus nephritis involves a combination of genetic, environmental, and immune system factors. The condition is primarily driven by a type III hypersensitivity reaction, which leads to the formation of immune complexes. Anti-double-stranded deoxyribonucleic acid (anti-dsDNA) antibodies bind to DNA, which forms anti-dsDNA immune complexes. These immune complexes deposit in the mesangium, subendothelial, or subepithelial spaces near the glomerular basement membrane, triggering an inflammatory response. This activates the complement pathway, resulting in the influx of neutrophils and other inflammatory cells, which contribute to the development of lupus nephritis. […] As with many other autoimmune diseases, genetic predilection has a significant role in the development of SLE and lupus nephritis. The loss of self-tolerance is considered a polygenic phenomenon, although this is incompletely understood. Over 50 genetic polymorphisms have been linked to the development of lupus nephritis, including those involving platelet-derived growth factor receptor-alpha, apolipoprotein L1, and hyaluronan synthase 2. Human leukocytic antigen (HLA) alleles are also associated with lupus nephritis. Specifically, HLA-DR3 and HLA-DR15 increase the risk of lupus nephritis, particularly in patients of European descent, whereas HLA-DR4 and HLA-DR11 appear to offer protective effects.

• #40 Lupus Nephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499817/

  Lupus nephritis can progress in severity over time through a phenomenon called „epitope spreading,” where autoantibodies initially recognize one epitope, then expand to recognize additional epitopes on the same molecule, followed by recognition of epitopes on other molecules. […] Anti-dsDNA antibodies are a hallmark of SLE, with apoptotic cells providing the extracellular DNA against which these antibodies are directed. […] Uncontrolled complement activation also contributes to the pathogenesis of SLE, involving all 3 complement pathways. Low C3 levels are more strongly correlated with lupus nephritis than low C4 levels, highlighting the significance of the alternative complement pathway in this process.

• #41 Lupus Nephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499817/

  Lupus nephritis can progress in severity over time through a phenomenon called „epitope spreading,” where autoantibodies initially recognize one epitope, then expand to recognize additional epitopes on the same molecule, followed by recognition of epitopes on other molecules. […] Anti-dsDNA antibodies are a hallmark of SLE, with apoptotic cells providing the extracellular DNA against which these antibodies are directed. […] Uncontrolled complement activation also contributes to the pathogenesis of SLE, involving all 3 complement pathways. Low C3 levels are more strongly correlated with lupus nephritis than low C4 levels, highlighting the significance of the alternative complement pathway in this process.

• #42 Lupus Nephritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499817/

  Lupus nephritis can progress in severity over time through a phenomenon called „epitope spreading,” where autoantibodies initially recognize one epitope, then expand to recognize additional epitopes on the same molecule, followed by recognition of epitopes on other molecules. […] Anti-dsDNA antibodies are a hallmark of SLE, with apoptotic cells providing the extracellular DNA against which these antibodies are directed. […] Uncontrolled complement activation also contributes to the pathogenesis of SLE, involving all 3 complement pathways. Low C3 levels are more strongly correlated with lupus nephritis than low C4 levels, highlighting the significance of the alternative complement pathway in this process.

• #43 Lupus nephritis: Diagnosis and classification – UpToDate

  https://www.uptodate.com/contents/lupus-nephritis-diagnosis-and-classification

  Lupus nephritis (LN) typically develops early in the disease course. […] The incidence of LN is higher in Black patients with SLE (34 to 51 percent), Hispanic patients (31 to 43 percent), and Asian patients (33 to 55 percent) than it is in White patients (14 to 23 percent). […] A number of patient characteristics place patients with LN at greater risk for progressive kidney disease including African or Hispanic ancestry, male sex, pediatric onset, frequent relapses or incomplete remission, and proteinuria >4 g/day at diagnosis. […] The pathogenesis may involve the expression of genes, both in the peripheral blood as well as in the kidneys, leading to neutrophil activation and increased expression of interferon and upregulation of myeloid cell and proinflammatory transcriptomes. […] Although kidney disease is primarily due to anti-dsDNA complexes, some data suggest that autoantibodies against C1q, a complement component, may correlate with LN.

• #44 Lupus nephritis: Diagnosis and classification – UpToDate

  https://www.uptodate.com/contents/lupus-nephritis-diagnosis-and-classification

  Lupus nephritis (LN) typically develops early in the disease course. […] The incidence of LN is higher in Black patients with SLE (34 to 51 percent), Hispanic patients (31 to 43 percent), and Asian patients (33 to 55 percent) than it is in White patients (14 to 23 percent). […] A number of patient characteristics place patients with LN at greater risk for progressive kidney disease including African or Hispanic ancestry, male sex, pediatric onset, frequent relapses or incomplete remission, and proteinuria >4 g/day at diagnosis. […] The pathogenesis may involve the expression of genes, both in the peripheral blood as well as in the kidneys, leading to neutrophil activation and increased expression of interferon and upregulation of myeloid cell and proinflammatory transcriptomes. […] Although kidney disease is primarily due to anti-dsDNA complexes, some data suggest that autoantibodies against C1q, a complement component, may correlate with LN.

• #45 Lupus Nephritis | Diagnosis & Disease Information

  https://www.rheumatologyadvisor.com/ddi/lupus-nephritis/

  Lupus nephritis is one of the more common and severe manifestations of systemic lupus erythematosus (SLE). […] The etiology and pathophysiology of SLE and lupus nephritis are not completely understood. Lupus nephritis can occur as a complication of systemic lupus erythematosus when the immune system loses the mechanisms that normally assure the immune tolerance of nuclear autoantigens. […] The loss of tolerance can result in excessive T helper cell and B cell activation that leads to the production of autoantibodies and complement activation that causes inflammation. When inflammation occurs in the kidneys, it results in lupus nephritis. […] Risk factors associated with developing lupus nephritis include the following: African American, Asian, Pacific Islander, or Hispanic race/ethnicity; Juvenile-onset SLE; and Male sex.

• #46 Lupus & Kidney Disease (Lupus Nephritis) – NIDDK

  https://www.niddk.nih.gov/health-information/kidney-disease/lupus-nephritis

  Lupus nephritis is a type of kidney disease caused by systemic lupus erythematosus (SLE or lupus). […] Kidney damage is one of the more common health problems caused by lupus. […] African Americans, Hispanics/Latinos, and Asian Americans are more likely to develop lupus nephritis than Caucasians. […] Lupus nephritis is more common in men than in women. […] A kidney biopsy can confirm a diagnosis of lupus nephritis. […] Health care professionals treat lupus nephritis with medicines that suppress your immune system so it stops attacking and damaging your kidneys. […] Between 10 to 30 percent of people who have lupus nephritis develop kidney failure. […] The most severe form of lupus nephritis, called diffuse proliferative nephritis, can cause scars to form in the kidneys. […] People who have lupus nephritis are at a high risk for cancer, primarily B-cell lymphoma.

• #47 Who Is Most Likely to Get Lupus Nephritis? Symptoms, 6 Risk Factors

  https://www.medicinenet.com/who_is_most_likely_to_get_lupus_nephritis/article.htm

  Lupus nephritis The six risk factors for developing lupus nephritis include the following. Risk factors for developing lupus nephritis include the following: Ethnicity: If you are African American, Hispanic or Latino, or Asian American. Gene: Those with the APOL-1 gene have an increased risk of developing kidney disease and lupus nephritis. Gender: Lupus nephritis is more common in men than in women although lupus itself is common in women. Age: Lupus nephritis is more common if you have had the first symptom of lupus as a child. Compared to adults with lupus (5 out of 10 get lupus nephritis), about 8 of 10 kids with lupus progress to lupus nephritis. Family history: If a family member has lupus nephritis, you are at a higher risk of the ailment. Lupus resistant to treatment: If your lupus does not respond to first-line treatment (steroids) and requires other immunosuppressive drugs, you are more likely to develop lupus nephritis in subsequent years.

• #48 Who Is Most Likely to Get Lupus Nephritis? Symptoms, 6 Risk Factors

  https://www.medicinenet.com/who_is_most_likely_to_get_lupus_nephritis/article.htm

  Lupus nephritis The six risk factors for developing lupus nephritis include the following. Risk factors for developing lupus nephritis include the following: Ethnicity: If you are African American, Hispanic or Latino, or Asian American. Gene: Those with the APOL-1 gene have an increased risk of developing kidney disease and lupus nephritis. Gender: Lupus nephritis is more common in men than in women although lupus itself is common in women. Age: Lupus nephritis is more common if you have had the first symptom of lupus as a child. Compared to adults with lupus (5 out of 10 get lupus nephritis), about 8 of 10 kids with lupus progress to lupus nephritis. Family history: If a family member has lupus nephritis, you are at a higher risk of the ailment. Lupus resistant to treatment: If your lupus does not respond to first-line treatment (steroids) and requires other immunosuppressive drugs, you are more likely to develop lupus nephritis in subsequent years.

• #49 Lupus nephritis – Symptoms, treatment and complications – American Kidney Fund (AKF)

  https://www.kidneyfund.org/all-about-kidneys/other-kidney-diseases/lupus-nephritis-symptoms-treatment-and-complications

  Lupus is an autoimmune disease. Autoimmune diseases cause your immune system to attack your healthy cells. Lupus can affect many parts of the body. When your immune system attacks your kidneys, it is called lupus nephritis. The most severe kind of lupus nephritis is proliferative nephritis, which can cause permanent damage to your kidneys. Many experts believe the cause of lupus is a combination of genetic and environmental factors. […] People who have a family member with lupus nephritis are also at a higher risk. If you have a family member with lupus, you should share this information with your doctor and ask if you need to be tested. Many experts believe the cause of lupus is a combination of genetic and environmental factors. For example, having the APOL-1 gene can increase your risk of developing kidney disease and lupus nephritis.

• #50 Who Is Most Likely to Get Lupus Nephritis? Symptoms, 6 Risk Factors

  https://www.medicinenet.com/who_is_most_likely_to_get_lupus_nephritis/article.htm

  Lupus nephritis The six risk factors for developing lupus nephritis include the following. Risk factors for developing lupus nephritis include the following: Ethnicity: If you are African American, Hispanic or Latino, or Asian American. Gene: Those with the APOL-1 gene have an increased risk of developing kidney disease and lupus nephritis. Gender: Lupus nephritis is more common in men than in women although lupus itself is common in women. Age: Lupus nephritis is more common if you have had the first symptom of lupus as a child. Compared to adults with lupus (5 out of 10 get lupus nephritis), about 8 of 10 kids with lupus progress to lupus nephritis. Family history: If a family member has lupus nephritis, you are at a higher risk of the ailment. Lupus resistant to treatment: If your lupus does not respond to first-line treatment (steroids) and requires other immunosuppressive drugs, you are more likely to develop lupus nephritis in subsequent years.

• #51 Who Is Most Likely to Get Lupus Nephritis? Symptoms, 6 Risk Factors

  https://www.medicinenet.com/who_is_most_likely_to_get_lupus_nephritis/article.htm

  Lupus nephritis The six risk factors for developing lupus nephritis include the following. Risk factors for developing lupus nephritis include the following: Ethnicity: If you are African American, Hispanic or Latino, or Asian American. Gene: Those with the APOL-1 gene have an increased risk of developing kidney disease and lupus nephritis. Gender: Lupus nephritis is more common in men than in women although lupus itself is common in women. Age: Lupus nephritis is more common if you have had the first symptom of lupus as a child. Compared to adults with lupus (5 out of 10 get lupus nephritis), about 8 of 10 kids with lupus progress to lupus nephritis. Family history: If a family member has lupus nephritis, you are at a higher risk of the ailment. Lupus resistant to treatment: If your lupus does not respond to first-line treatment (steroids) and requires other immunosuppressive drugs, you are more likely to develop lupus nephritis in subsequent years.

• #52 Lupus & Kidney Disease (Lupus Nephritis) – NIDDK

  https://www.niddk.nih.gov/health-information/kidney-disease/lupus-nephritis

  Lupus nephritis is a type of kidney disease caused by systemic lupus erythematosus (SLE or lupus). […] Kidney damage is one of the more common health problems caused by lupus. […] African Americans, Hispanics/Latinos, and Asian Americans are more likely to develop lupus nephritis than Caucasians. […] Lupus nephritis is more common in men than in women. […] A kidney biopsy can confirm a diagnosis of lupus nephritis. […] Health care professionals treat lupus nephritis with medicines that suppress your immune system so it stops attacking and damaging your kidneys. […] Between 10 to 30 percent of people who have lupus nephritis develop kidney failure. […] The most severe form of lupus nephritis, called diffuse proliferative nephritis, can cause scars to form in the kidneys. […] People who have lupus nephritis are at a high risk for cancer, primarily B-cell lymphoma.

• #53 Who Is Most Likely to Get Lupus Nephritis? Symptoms, 6 Risk Factors

  https://www.medicinenet.com/who_is_most_likely_to_get_lupus_nephritis/article.htm

  The development of lupus nephritis depends on your ethnicity, response to lupus treatment, lifestyle, and environmental factors. Hence, it is difficult to predict and prevent lupus nephritis. […] About 10 to 30 percent of those who suffer from lupus nephritis eventually progress to kidney failure or end-stage renal disease (ESRD). Compared to those with healthy kidneys, patients with renal disease, renal damage, and ESRD with lupus had about 2.2 to 9.2 times higher risk of death. This is because those with lupus nephritis are susceptible to certain cancers, cardiovascular diseases, electrolyte imbalances, and strokes compared to the average population.

• #54 Lupus & Kidney Disease (Lupus Nephritis) – NIDDK

  https://www.niddk.nih.gov/health-information/kidney-disease/lupus-nephritis

  Lupus nephritis is a type of kidney disease caused by systemic lupus erythematosus (SLE or lupus). […] Kidney damage is one of the more common health problems caused by lupus. […] African Americans, Hispanics/Latinos, and Asian Americans are more likely to develop lupus nephritis than Caucasians. […] Lupus nephritis is more common in men than in women. […] A kidney biopsy can confirm a diagnosis of lupus nephritis. […] Health care professionals treat lupus nephritis with medicines that suppress your immune system so it stops attacking and damaging your kidneys. […] Between 10 to 30 percent of people who have lupus nephritis develop kidney failure. […] The most severe form of lupus nephritis, called diffuse proliferative nephritis, can cause scars to form in the kidneys. […] People who have lupus nephritis are at a high risk for cancer, primarily B-cell lymphoma.

• #55 Lupus Nephritis – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/glomerular-disorders/lupus-nephritis

  Lupus nephritis is glomerulonephritis caused by systemic lupus erythematosus (SLE). […] Lupus nephritis is present in 20 to 60% of patients with SLE (1). […] Pathophysiology involves immune complex deposition with development of glomerulonephritis. […] In antiphospholipid syndrome, circulating lupus anticoagulant causes microthrombi, endothelial damage, and cortical ischemic atrophy. […] Class of nephritis influences renal prognosis (see table Classification of Lupus Nephritis), as do other renal histologic features, baseline kidney function, and race (1). […] Patients with lupus nephritis are at high risk of cancers, primarily B-cell lymphomas. Risk of atherosclerotic complications (eg, coronary artery disease, ischemic stroke) is also high because of frequent vasculitis, hypertension, dyslipidemia, and use of corticosteroids.

• #56 Lupus nephritis: Diagnosis and classification – UpToDate

  https://www.uptodate.com/contents/lupus-nephritis-diagnosis-and-classification

  Lupus nephritis (LN) typically develops early in the disease course. […] The incidence of LN is higher in Black patients with SLE (34 to 51 percent), Hispanic patients (31 to 43 percent), and Asian patients (33 to 55 percent) than it is in White patients (14 to 23 percent). […] A number of patient characteristics place patients with LN at greater risk for progressive kidney disease including African or Hispanic ancestry, male sex, pediatric onset, frequent relapses or incomplete remission, and proteinuria >4 g/day at diagnosis. […] The pathogenesis may involve the expression of genes, both in the peripheral blood as well as in the kidneys, leading to neutrophil activation and increased expression of interferon and upregulation of myeloid cell and proinflammatory transcriptomes. […] Although kidney disease is primarily due to anti-dsDNA complexes, some data suggest that autoantibodies against C1q, a complement component, may correlate with LN.

• #57 Lupus & Kidney Disease (Lupus Nephritis) – NIDDK

  https://www.niddk.nih.gov/health-information/kidney-disease/lupus-nephritis

  Lupus nephritis is a type of kidney disease caused by systemic lupus erythematosus (SLE or lupus). […] Kidney damage is one of the more common health problems caused by lupus. […] African Americans, Hispanics/Latinos, and Asian Americans are more likely to develop lupus nephritis than Caucasians. […] Lupus nephritis is more common in men than in women. […] A kidney biopsy can confirm a diagnosis of lupus nephritis. […] Health care professionals treat lupus nephritis with medicines that suppress your immune system so it stops attacking and damaging your kidneys. […] Between 10 to 30 percent of people who have lupus nephritis develop kidney failure. […] The most severe form of lupus nephritis, called diffuse proliferative nephritis, can cause scars to form in the kidneys. […] People who have lupus nephritis are at a high risk for cancer, primarily B-cell lymphoma.

• #58 Lupus Nephritis: What Is It, Causes, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/21809-lupus-nephritis

  Lupus nephritis is kidney inflammation due to lupus, an autoimmune disease. About half of adults and 80% of children with lupus will develop lupus nephritis. […] Lupus nephritis is inflammation and damage in your kidneys due to systemic lupus erythematosus (SLE). SLE is the most common form of lupus. Lupus is an autoimmune disease that triggers your immune system to attack your tissues. […] In lupus nephritis, your body attacks your kidney, which leads to inflammation and abnormal kidney function. Long-term inflammation leads to scarring and permanent kidney damage. […] Only adults and children with lupus can develop lupus nephritis. […] About 50% of adults with lupus will develop lupus nephritis. About 80% of children with lupus will develop this kidney condition.

• #59 Diagnosis and treatment of lupus nephritis. Consensus document from the systemic auto-immune disease group (GEAS) of the Spanish Society of Internal Medicine (SEMI) and the Spanish Society of Nephrology (S.E.N.) | N

  https://www.revistanefrologia.com/en-diagnosis-treatment-lupus-nephritis-consensus-articulo-X2013251412000644

  Lupus nephritis affects over half of all patients with systemic lupus erythematosus (SLE). This condition increases mortality and morbidity rates among patients due to, among other reasons, the risk of chronic kidney disease with the need for renal replacement therapy in approximately 25% of cases. […] Lupus nephritis should be classified according to the histological classes defined in 2003 by the International Society of Nephrology (ISN) and the Renal Pathology Society (RPS) (NG). The histopathological diagnosis plays a leading role in establishing a prognosis and treatment. […] A renal biopsy is mandatory in patients with SLE and tests results indicative of renal involvement, such as increased creatinine, reduced glomerular filtration rate, proteinuria, haematuria, and active urinary sediments.

• #60 6 Classes of Lupus Nephritis: Diagnosis and Treatment | MyLupusTeam

  https://www.mylupusteam.com/resources/lupus-nephritis-stages

  Lupus nephritis is a kidney disease caused by systemic lupus erythematosus (SLE or lupus). In lupus, the immune system makes antibodies that mistakenly attack the bodys organs and tissues, including the kidneys. These antibodies can harm the kidneys by building up in the tissue and affecting how they work. […] When glomeruli and mesangial cells become damaged, the kidneys cannot properly remove waste and excess fluid from the blood. […] Damage to these structures, including their mesangial cells, is a hallmark of lupus nephritis and helps determine its stage. […] There are six classes of lupus nephritis. The classes are defined by the amount of damage to the kidneys and renal function (how well the kidney works). […] Class 1 (class I) is diagnosed when theres little or no kidney damage, but some immune activity called an immune deposit or immune complex is present.

• #61 6 Classes of Lupus Nephritis: Diagnosis and Treatment | MyLupusTeam

  https://www.mylupusteam.com/resources/lupus-nephritis-stages

  Class 2 (class II) involves some kidney damage, unlike class 1. […] In class 3 (class III), 50 percent or less of the glomeruli in the kidneys have been affected. […] A person is diagnosed with class 4 (class IV) lupus nephritis when more than 50 percent of their glomeruli have been affected. […] In class 5 (class V) lupus nephritis, a pathologist may find an excessive amount of immune complexes in the kidneys. […] Class 6 (class VI) lupus nephritis occurs when more than 90 percent of the glomeruli in the kidney are damaged. […] The immunosuppressive treatment used for these classes is stronger because starting treatment at the right time can help prevent permanent kidney damage.

• #62 6 Classes of Lupus Nephritis: Diagnosis and Treatment | MyLupusTeam

  https://www.mylupusteam.com/resources/lupus-nephritis-stages

  Class 2 (class II) involves some kidney damage, unlike class 1. […] In class 3 (class III), 50 percent or less of the glomeruli in the kidneys have been affected. […] A person is diagnosed with class 4 (class IV) lupus nephritis when more than 50 percent of their glomeruli have been affected. […] In class 5 (class V) lupus nephritis, a pathologist may find an excessive amount of immune complexes in the kidneys. […] Class 6 (class VI) lupus nephritis occurs when more than 90 percent of the glomeruli in the kidney are damaged. […] The immunosuppressive treatment used for these classes is stronger because starting treatment at the right time can help prevent permanent kidney damage.

• #63 6 Classes of Lupus Nephritis: Diagnosis and Treatment | MyLupusTeam

  https://www.mylupusteam.com/resources/lupus-nephritis-stages

  Class 2 (class II) involves some kidney damage, unlike class 1. […] In class 3 (class III), 50 percent or less of the glomeruli in the kidneys have been affected. […] A person is diagnosed with class 4 (class IV) lupus nephritis when more than 50 percent of their glomeruli have been affected. […] In class 5 (class V) lupus nephritis, a pathologist may find an excessive amount of immune complexes in the kidneys. […] Class 6 (class VI) lupus nephritis occurs when more than 90 percent of the glomeruli in the kidney are damaged. […] The immunosuppressive treatment used for these classes is stronger because starting treatment at the right time can help prevent permanent kidney damage.

• #64 6 Classes of Lupus Nephritis: Diagnosis and Treatment | MyLupusTeam

  https://www.mylupusteam.com/resources/lupus-nephritis-stages

  Class 2 (class II) involves some kidney damage, unlike class 1. […] In class 3 (class III), 50 percent or less of the glomeruli in the kidneys have been affected. […] A person is diagnosed with class 4 (class IV) lupus nephritis when more than 50 percent of their glomeruli have been affected. […] In class 5 (class V) lupus nephritis, a pathologist may find an excessive amount of immune complexes in the kidneys. […] Class 6 (class VI) lupus nephritis occurs when more than 90 percent of the glomeruli in the kidney are damaged. […] The immunosuppressive treatment used for these classes is stronger because starting treatment at the right time can help prevent permanent kidney damage.

• #65 6 Classes of Lupus Nephritis: Diagnosis and Treatment | MyLupusTeam

  https://www.mylupusteam.com/resources/lupus-nephritis-stages

  Class 2 (class II) involves some kidney damage, unlike class 1. […] In class 3 (class III), 50 percent or less of the glomeruli in the kidneys have been affected. […] A person is diagnosed with class 4 (class IV) lupus nephritis when more than 50 percent of their glomeruli have been affected. […] In class 5 (class V) lupus nephritis, a pathologist may find an excessive amount of immune complexes in the kidneys. […] Class 6 (class VI) lupus nephritis occurs when more than 90 percent of the glomeruli in the kidney are damaged. […] The immunosuppressive treatment used for these classes is stronger because starting treatment at the right time can help prevent permanent kidney damage.

• #66 What is Lupus Nephritis? Treatment and Overview | HSS

  https://www.hss.edu/conditions_lupus-nephritis-what-you-need-to-know-about-lupus-kidney-disease.asp

  For reasons that are not yet fully understood, women develop lupus far more frequently than do men (at a ratio of 9:1) and women of African, Asian and Hispanic descent are at greater risk than their Caucasian counterparts, which suggests a genetic cause. […] Moreover, lupus nephritis usually develops in people with more severe forms of lupus. […] In the case of classes III and IV, the biopsy will also indicate the proportion of glomeruli with inflammation (active) and with scar tissue (sclerotic). […] If a person is found to have Class VI disease, or advanced sclerosing lupus nephritis, the kidney contains only scar tissue without active inflammation, and therefore aggressive treatment with immunosuppressive drugs is not indicated. […] People with the more severe forms of lupus nephritis, classes III, IV and V (with nephrotic proteinuria), need to be started on an aggressive course of treatment that is also referred to as induction therapy, since the goal is to induce a remission of the inflammation and related symptoms. […] The duration of induction therapy can range from three months to one year. […] Unfortunately, people who are successfully treated for lupus nephritis remain at risk of recurrence for the condition.

• #67 Lupus Nephritis – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/glomerular-disorders/lupus-nephritis

  Lupus nephritis is glomerulonephritis caused by systemic lupus erythematosus (SLE). […] Lupus nephritis is present in 20 to 60% of patients with SLE (1). […] Pathophysiology involves immune complex deposition with development of glomerulonephritis. […] In antiphospholipid syndrome, circulating lupus anticoagulant causes microthrombi, endothelial damage, and cortical ischemic atrophy. […] Class of nephritis influences renal prognosis (see table Classification of Lupus Nephritis), as do other renal histologic features, baseline kidney function, and race (1). […] Patients with lupus nephritis are at high risk of cancers, primarily B-cell lymphomas. Risk of atherosclerotic complications (eg, coronary artery disease, ischemic stroke) is also high because of frequent vasculitis, hypertension, dyslipidemia, and use of corticosteroids.

• #68 Diagnosing Lupus Nephritis > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/lupus-nephritis

  Lupus nephritis is an autoimmune disease that causes rampant inflammation throughout the body. […] A diagnosis of lupus nephritis is a sign that lupus is advancing at a dangerous pace, Dr. Moeckel says. Lupus nephritis is very aggressive and it can rapidly lead to end-stage renal (kidney) disease, he says. […] The kidney biopsy is the gold standard for the diagnosis of lupus nephritis,” Dr. Moeckel says. […] The degree of disease activity correlates with the amount of inflammation in the kidney, Dr. Moeckel adds. […] If lupus nephritis is suspected, doctors will order a kidney biopsy, which can be performed on an outpatient basis. […] The tissue will undergo many tests to determine the presence and extent of the immune-mediated injury by lupus. […] The findings are then given a designated type and activity grade that reflects how aggressively the disease has attacked the kidney. […] The accurate type and grade is conveyed to the clinician, who then uses this information to determine how to treat a particular patients lupus-related kidney disease.

• #69 Lupus Nephritis Risk Factors and Biomarkers: An Update

  https://www.mdpi.com/1422-0067/24/19/14526

  Lupus nephritis (LN) represents the most severe organ manifestation of systemic lupus erythematosus (SLE) in terms of morbidity and mortality. […] Lupus nephritis (LN) is a frequent manifestation of systemic lupus erythematosus (SLE) for which current therapies are insufficiently effective and, in some cases, toxic due to important individual differences. […] At LN diagnosis, the gold standard technique is kidney biopsy that allows for LN histological assessment and prognosis, but its use is limited due to invasiveness. […] The prevalence of LN varies by race and ethnicity with African/Caribbean and Asian/Pacific islanders at high risk (35–80%), Hispanic (30–50%) at moderate risk, and Caucasian at low risk (15–25%). […] Heritability is high in SLE, which results in a relative risk to develop SLE estimated at 30% in monozygotic twins to 5–7% in dizygotic twins and first-degree relatives, with males being rarely affected.

• #70 Diagnosis and treatment of lupus nephritis. Consensus document from the systemic auto-immune disease group (GEAS) of the Spanish Society of Internal Medicine (SEMI) and the Spanish Society of Nephrology (S.E.N.) | N

  https://www.revistanefrologia.com/en-diagnosis-treatment-lupus-nephritis-consensus-articulo-X2013251412000644

  Lupus nephritis affects over half of all patients with systemic lupus erythematosus (SLE). This condition increases mortality and morbidity rates among patients due to, among other reasons, the risk of chronic kidney disease with the need for renal replacement therapy in approximately 25% of cases. […] Lupus nephritis should be classified according to the histological classes defined in 2003 by the International Society of Nephrology (ISN) and the Renal Pathology Society (RPS) (NG). The histopathological diagnosis plays a leading role in establishing a prognosis and treatment. […] A renal biopsy is mandatory in patients with SLE and tests results indicative of renal involvement, such as increased creatinine, reduced glomerular filtration rate, proteinuria, haematuria, and active urinary sediments.

• #71 Lupus & Kidney Disease (Lupus Nephritis) – NIDDK

  https://www.niddk.nih.gov/health-information/kidney-disease/lupus-nephritis

  Lupus nephritis is a type of kidney disease caused by systemic lupus erythematosus (SLE or lupus). […] Kidney damage is one of the more common health problems caused by lupus. […] African Americans, Hispanics/Latinos, and Asian Americans are more likely to develop lupus nephritis than Caucasians. […] Lupus nephritis is more common in men than in women. […] A kidney biopsy can confirm a diagnosis of lupus nephritis. […] Health care professionals treat lupus nephritis with medicines that suppress your immune system so it stops attacking and damaging your kidneys. […] Between 10 to 30 percent of people who have lupus nephritis develop kidney failure. […] The most severe form of lupus nephritis, called diffuse proliferative nephritis, can cause scars to form in the kidneys. […] People who have lupus nephritis are at a high risk for cancer, primarily B-cell lymphoma.

• #72 Lupus nephritis | Kidney Care UK

  https://kidneycareuk.org/kidney-disease-information/kidney-conditions/lupus-nephritis/

  Lupus nephritis is a kidney condition caused by the autoimmune disease systemic lupus erythematosus (SLE). […] In lupus nephritis the body’s immune system attacks the kidney, particularly the filtering structures in the kidney called glomeruli (there are around a million of these in the kidneys), causing inflammation. […] Around 60 per cent of lupus patients will develop lupus nephritis at some point during their illness. […] There are a number of treatments available for lupus nephritis, which aim to preserve kidney function, prevent disease flare ups, and improve quality of life and survival. […] The standard immunosuppressant drugs for lupus nephritis include mycophenolate and cyclophosphamide (or sometimes azathioprine) and work by suppressing the immune system to stop damage to the kidneys from antibodies. […] Having an autoimmune disease such as lupus can raise the risk of cardiovascular disease.

• #73 Lupus nephritis | Kidney Care UK

  https://kidneycareuk.org/kidney-disease-information/kidney-conditions/lupus-nephritis/

  Lupus nephritis is a kidney condition caused by the autoimmune disease systemic lupus erythematosus (SLE). […] In lupus nephritis the body’s immune system attacks the kidney, particularly the filtering structures in the kidney called glomeruli (there are around a million of these in the kidneys), causing inflammation. […] Around 60 per cent of lupus patients will develop lupus nephritis at some point during their illness. […] There are a number of treatments available for lupus nephritis, which aim to preserve kidney function, prevent disease flare ups, and improve quality of life and survival. […] The standard immunosuppressant drugs for lupus nephritis include mycophenolate and cyclophosphamide (or sometimes azathioprine) and work by suppressing the immune system to stop damage to the kidneys from antibodies. […] Having an autoimmune disease such as lupus can raise the risk of cardiovascular disease.

• #74 Lupus and the Kidneys | Lupus Foundation of America

  https://www.lupus.org/resources/how-lupus-affects-the-renal-kidney-system

  Lupus can cause a kidney disease called lupus nephritis. Lupus nephritis is inflammation in the kidneys that can make them stop working. […] Lupus nephritis is most common in people ages 20 to 40. It usually starts within 5 years of your first lupus symptoms. […] Since lupus nephritis may not cause symptoms at first, it’s important that people with lupus get tested for kidney problems. Your doctor or a special doctor called a nephrologist can find out if you have lupus nephritis or other problems in your urinary system. […] Medicines to treat lupus nephritis include: Lupkynis (voclosporin), Benlysta, Steroids, like prednisone, Immunosuppressives, like mycophenolate mofetil (CellCept).

• #75 What is Lupus Nephritis? Treatment and Overview | HSS

  https://www.hss.edu/conditions_lupus-nephritis-what-you-need-to-know-about-lupus-kidney-disease.asp

  For reasons that are not yet fully understood, women develop lupus far more frequently than do men (at a ratio of 9:1) and women of African, Asian and Hispanic descent are at greater risk than their Caucasian counterparts, which suggests a genetic cause. […] Moreover, lupus nephritis usually develops in people with more severe forms of lupus. […] In the case of classes III and IV, the biopsy will also indicate the proportion of glomeruli with inflammation (active) and with scar tissue (sclerotic). […] If a person is found to have Class VI disease, or advanced sclerosing lupus nephritis, the kidney contains only scar tissue without active inflammation, and therefore aggressive treatment with immunosuppressive drugs is not indicated. […] People with the more severe forms of lupus nephritis, classes III, IV and V (with nephrotic proteinuria), need to be started on an aggressive course of treatment that is also referred to as induction therapy, since the goal is to induce a remission of the inflammation and related symptoms. […] The duration of induction therapy can range from three months to one year. […] Unfortunately, people who are successfully treated for lupus nephritis remain at risk of recurrence for the condition.

• #76 What is Lupus Nephritis? Treatment and Overview | HSS

  https://www.hss.edu/conditions_lupus-nephritis-what-you-need-to-know-about-lupus-kidney-disease.asp

  For reasons that are not yet fully understood, women develop lupus far more frequently than do men (at a ratio of 9:1) and women of African, Asian and Hispanic descent are at greater risk than their Caucasian counterparts, which suggests a genetic cause. […] Moreover, lupus nephritis usually develops in people with more severe forms of lupus. […] In the case of classes III and IV, the biopsy will also indicate the proportion of glomeruli with inflammation (active) and with scar tissue (sclerotic). […] If a person is found to have Class VI disease, or advanced sclerosing lupus nephritis, the kidney contains only scar tissue without active inflammation, and therefore aggressive treatment with immunosuppressive drugs is not indicated. […] People with the more severe forms of lupus nephritis, classes III, IV and V (with nephrotic proteinuria), need to be started on an aggressive course of treatment that is also referred to as induction therapy, since the goal is to induce a remission of the inflammation and related symptoms. […] The duration of induction therapy can range from three months to one year. […] Unfortunately, people who are successfully treated for lupus nephritis remain at risk of recurrence for the condition.

• #77 What is Lupus Nephritis? Treatment and Overview | HSS

  https://www.hss.edu/conditions_lupus-nephritis-what-you-need-to-know-about-lupus-kidney-disease.asp

  For reasons that are not yet fully understood, women develop lupus far more frequently than do men (at a ratio of 9:1) and women of African, Asian and Hispanic descent are at greater risk than their Caucasian counterparts, which suggests a genetic cause. […] Moreover, lupus nephritis usually develops in people with more severe forms of lupus. […] In the case of classes III and IV, the biopsy will also indicate the proportion of glomeruli with inflammation (active) and with scar tissue (sclerotic). […] If a person is found to have Class VI disease, or advanced sclerosing lupus nephritis, the kidney contains only scar tissue without active inflammation, and therefore aggressive treatment with immunosuppressive drugs is not indicated. […] People with the more severe forms of lupus nephritis, classes III, IV and V (with nephrotic proteinuria), need to be started on an aggressive course of treatment that is also referred to as induction therapy, since the goal is to induce a remission of the inflammation and related symptoms. […] The duration of induction therapy can range from three months to one year. […] Unfortunately, people who are successfully treated for lupus nephritis remain at risk of recurrence for the condition.

• #78 Diagnosis and treatment of lupus nephritis. Consensus document from the systemic auto-immune disease group (GEAS) of the Spanish Society of Internal Medicine (SEMI) and the Spanish Society of Nephrology (S.E.N.) | N

  https://www.revistanefrologia.com/en-diagnosis-treatment-lupus-nephritis-consensus-articulo-X2013251412000644

  The indications for a second biopsy are more debatable for two reasons: the possible complications, and the doubts concerning their influence in treating patients. […] The responses must be evaluated according to the criteria for complete and partial responses (NG). Responses are based on the evolution of creatinine, proteinuria, and urinary sediment values as compared to baseline values (NG). […] Recurrences in patients that have reached a good response to treatment should be evaluated for the appearance of proteinuria, increased creatinine levels, changes in urinary sediments, and, in general, the presence of immunological activity (NG). […] There is no standard definition for the patterns of response to treatment, although all are based upon the values observed in basic laboratory variables.

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