Materiały źródłowe

• #1 Lupus nephritis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lupus-nephritis/symptoms-causes/syc-20354335

  Lupus nephritis is a problem that occurs often in people who have systemic lupus erythematosus, also called lupus. […] 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. […] Signs and symptoms of lupus nephritis include: Blood in the urine. Urine that foams because of too much protein. High blood pressure. Swelling in the legs, ankles or feet and sometimes in the hands and face. High levels of a waste product called creatinine in the blood.

• #2 Lupus and kidney disease (lupus nephritis) – Symptoms, treatment, & stages | National Kidney Foundation

  https://www.kidney.org/kidney-topics/lupus-nephritis

  Lupus nephritis is a disease that affects the kidneys, making it difficult for them to clean blood well. […] When you have LN, your kidneys are not doing a good job removing waste from your blood or controlling the amount of fluids in your body. […] In its early stages, LN has very few signs of anything wrong. Some people have no specific symptoms. Kidney problems can start around the same time lupus symptoms appear and may include: Swelling in the hands, face, feet, belly, or around the eyes; Weight changes usually weight gain, but sometimes weight loss; Feeling very tired; Brown urine caused by blood; Foamy urine caused by protein; Urinating (peeing) less often than normal; High blood pressure. […] A key feature of LN is proteinuria, which is HIGH levels of protein in the urine. […] Without diagnosis and treatment, LN usually gets worse over time, which can lead to kidney failure. This serious condition occurs when almost all (over 90%) of your kidney function is lost. […] Up to 3 out of 10 people with lupus nephritis will develop kidney failure within 15 years of diagnosis.

• #3 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. Symptoms can include fluid buildup in your body and increased urine output. About half of adults and 80% of children with lupus will develop lupus nephritis. […] Symptoms of lupus nephritis tend to develop about five years after lupus symptoms first appear. But lupus nephritis can be the first and sometimes the only manifestation of systemic lupus erythematosus (SLE). Lupus nephritis can cause: […] Edema (swelling due to fluid buildup) in your lower body or around your eyes. […] Increased urination, especially at night. […] Kidney failure develops in 10% to 30% of people with lupus nephritis. […] People who receive timely treatment for lupus nephritis have a positive outlook. […] Managing the condition with medication and diet changes may help delay or prevent kidney failure.

• #4 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. In adults who have lupus, as many as 5 out of 10 will have kidney disease. In children who have lupus, 8 of 10 will have kidney disease. […] The symptoms of lupus nephritis may include foamy urine and edema swelling that occurs when your body has too much fluid, usually in the legs, feet, or ankles, and less often in the hands or face. You may also develop high blood pressure. […] Kidney problems often start at the same time or shortly after lupus symptoms appear and can include joint pain or swelling, muscle pain, fever with no known cause, a red rash, often on the face, across the nose and cheeks, sometimes called a butterfly rash because of its shape.

• #5 Lupus Nephritis – StatPearls – NCBI Bookshelf

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

  Lupus nephritis is a severe manifestation of systemic lupus erythematosus (SLE) a chronic autoimmune disease that causes inflammation and damage to multiple organ systems, with the kidneys as a primary target. This condition often develops within 3 to 5 years of SLE onset and significantly increases the risk of end-stage renal disease (ESRD). […] Monitoring kidney function in patients with SLE is crucial, as early detection and management of renal impairment can significantly improve outcomes. Lupus nephritis typically develops 3 to 5 years after the onset of SLE. Histological evidence of lupus nephritis is present in most SLE patients, even when clinical signs of renal disease are not apparent. […] Given the high risk of increased morbidity, timely treatment is crucial to prevent progression to end-stage renal disease (ESRD). The primary objective of treatment is to normalize kidney function or, at the very least, prevent further decline.

• #6 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). […] Symptoms of lupus nephritis include: Frothy urine (a sign of protein in the urine), Brown urine (a sign of blood in the urine, although blood can also be present without being visible), swollen feet, ankles and hands, puffiness around the eyes and tummy, fatigue, high blood pressure. […] Around 60 per cent of lupus patients will develop lupus nephritis at some point during their illness. […] In lupus nephritis the body’s immune system attacks the kidney, particularly the filtering structures in the kidney called glomeruli, causing inflammation. […] If this is left untreated, the inflammation can progress to cause scarring and kidney failure, but drug treatments can help avoid this.

• #7 Lupus and kidney disease (lupus nephritis) – Symptoms, treatment, & stages | National Kidney Foundation

  https://www.kidney.org/kidney-topics/lupus-nephritis

  Lupus nephritis is a disease that affects the kidneys, making it difficult for them to clean blood well. […] When you have LN, your kidneys are not doing a good job removing waste from your blood or controlling the amount of fluids in your body. […] In its early stages, LN has very few signs of anything wrong. Some people have no specific symptoms. Kidney problems can start around the same time lupus symptoms appear and may include: Swelling in the hands, face, feet, belly, or around the eyes; Weight changes usually weight gain, but sometimes weight loss; Feeling very tired; Brown urine caused by blood; Foamy urine caused by protein; Urinating (peeing) less often than normal; High blood pressure. […] A key feature of LN is proteinuria, which is HIGH levels of protein in the urine. […] Without diagnosis and treatment, LN usually gets worse over time, which can lead to kidney failure. This serious condition occurs when almost all (over 90%) of your kidney function is lost. […] Up to 3 out of 10 people with lupus nephritis will develop kidney failure within 15 years of diagnosis.

• #8 Disease Progression of LN from SLE

  https://www.ajmc.com/view/disease-progression-of-ln-from-sle

  Lupus can affect many aspects of the body, including the scalp, skin, kidneys, heart, and lungs. Some patients have kidney involvement at the time of diagnosis of lupus. One way we tell is by doing a blood test to look for elevation of the creatinine, and then we do a urine test to look for protein in the urine, or proteinuria. The data show that of every 3 patients with lupus who present for the first time to a rheumatology clinic, 1 will have lupus nephritis. That triggers us to start aggressive therapy so that we dont let that patient progress to end-stage renal disease, which essentially means dialysis. Unfortunately, if patients have lupus nephritis, theyre 45 times more likely to get kidney disease than a patient without lupus nephritis. Thats a bad sign. […] With respect to the progressive nature of lupus nephritis over time, the disease tends to progress to transplant and dialysis. Depending on what you read, between 45% and 55% of patients with SLE [systemic lupus erythematosus] develop lupus nephritis. There are multiple histologic phases of lupus nephritis. Some remain stagnant, and others proceed in aggressive fashion to end-stage renal disease. Seventy percent of patients with lupus nephritis have stage III, IV, or V [disease], which tend to be the most aggressive [stages] with respect to the early intervention and management of the disease state. It can fluctuate. Many years in the past, we probably werent as aggressive with stage III. But now we recognize that the fluctuations and aggressiveness of the insult of the autoimmune disease can lead to significant deposition and rapid progression to the end stage, causing renal demise and ultimately patient survival and death.

• #9 Lupus Nephritis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/25699

  A common and severe manifestation of SLE that requires evaluation is kidney involvement, referred to as „lupus nephritis.” Monitoring kidney function in patients with SLE is crucial, as early detection and management of renal impairment can significantly improve outcomes. Lupus nephritis typically develops 3 to 5 years after the onset of SLE. […] Monitoring for the development of lupus nephritis involves serial assessments of creatinine levels, urine protein-to-creatinine ratio, and urinalysis. These tests help detect increases in serum creatinine and the presence of proteinuria, which is commonly observed in lupus nephritis. Given the high risk of increased morbidity, timely treatment is crucial to prevent progression to end-stage renal disease (ESRD). […] 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. This process involves both intramolecular and intermolecular epitope spreading.

• #10 Lupus Nephritis – StatPearls – NCBI Bookshelf

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

  Lupus nephritis is a severe manifestation of systemic lupus erythematosus (SLE) a chronic autoimmune disease that causes inflammation and damage to multiple organ systems, with the kidneys as a primary target. This condition often develops within 3 to 5 years of SLE onset and significantly increases the risk of end-stage renal disease (ESRD). […] Monitoring kidney function in patients with SLE is crucial, as early detection and management of renal impairment can significantly improve outcomes. Lupus nephritis typically develops 3 to 5 years after the onset of SLE. Histological evidence of lupus nephritis is present in most SLE patients, even when clinical signs of renal disease are not apparent. […] Given the high risk of increased morbidity, timely treatment is crucial to prevent progression to end-stage renal disease (ESRD). The primary objective of treatment is to normalize kidney function or, at the very least, prevent further decline.

• #11 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

  Signs of lupus nephritis may include: […] swelling or puffiness of feet, legs, eyes […] high blood pressure […] high protein levels in the urine […] frothy urine or getting up constantly to urinate at night […] blood in the urine. […] Moreover, lupus nephritis usually develops in people with more severe forms of lupus. […] 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. […] Unfortunately, people who are successfully treated for lupus nephritis remain at risk of recurrence for the condition. Therefore, regular monitoring of kidney function is essential, especially since the early signs of recurrence may only be detectable with laboratory tests.

• #12 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. When the kidneys aren’t working well, waste builds up in the blood and extra water builds up in the body. […] Lupus nephritis is most common in people ages 20 to 40. It usually starts within 5 years of your first lupus symptoms. […] In the early stages of lupus nephritis, you might not notice any symptoms. As the disease gets worse, it can cause the following symptoms: Swelling (usually in the feet, ankles, legs, or face), Foamy urine, Peeing more often than usual, especially at night, High blood pressure. […] 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.

• #13 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. Symptoms can include fluid buildup in your body and increased urine output. About half of adults and 80% of children with lupus will develop lupus nephritis. […] Symptoms of lupus nephritis tend to develop about five years after lupus symptoms first appear. But lupus nephritis can be the first and sometimes the only manifestation of systemic lupus erythematosus (SLE). Lupus nephritis can cause: […] Edema (swelling due to fluid buildup) in your lower body or around your eyes. […] Increased urination, especially at night. […] Kidney failure develops in 10% to 30% of people with lupus nephritis. […] People who receive timely treatment for lupus nephritis have a positive outlook. […] Managing the condition with medication and diet changes may help delay or prevent kidney failure.

• #14 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. […] Clinically evident kidney disease eventually occurs in up to one-half of patients with SLE, and up to 10 percent of patients with LN will develop end-stage kidney disease (ESKD). […] The most frequently observed abnormality in patients with lupus nephritis (LN) is proteinuria. Other common clinical manifestations include microscopic hematuria with or without red cell casts, kidney function impairment, nephrotic-range proteinuria or nephrotic syndrome, and hypertension. […] Most kidney abnormalities emerge soon after the diagnosis of SLE is made (commonly, within the first 6 to 36 months). […] Rarely, patients may have silent LN, in which significant abnormalities are observed on kidney biopsy without any clinical signs of kidney involvement.

• #15 Lupus Nephritis | Diagnosis & Disease Information

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

  Lupus nephritis is one of the more common and severe manifestations of systemic lupus erythematosus (SLE). […] Approximately 15% to 30% of patients have lupus nephritis at the time of SLE diagnosis, with more patients at risk of developing lupus nephritis over the course of their disease. An estimated 30% to 50% of patients with SLE will later develop lupus nephritis. […] The presence of lupus nephritis is a major factor in predicting the morbidity and mortality of patients with SLE and the need for renal replacement therapy. Approximately one-half of patients with lupus nephritis eventually progress to end-stage renal disease (ESRD). […] Proteinuria is often an early sign of renal involvement in SLE. However, there is great variation of symptoms between patients. […] In addition to proteinuria, signs and symptoms of lupus nephritis may include the following: abnormal renal function; abnormal urinary sediment; edema; fatigue; and hypertension. […] Lupus nephritis with nephrotic syndrome may manifest in the following ways: dyslipidemia; hypoalbuminemia; peripheral edema; and proteinuria.

• #16 Lupus and kidney disease (lupus nephritis) – Symptoms, treatment, & stages | National Kidney Foundation

  https://www.kidney.org/kidney-topics/lupus-nephritis

  Lupus nephritis is a disease that affects the kidneys, making it difficult for them to clean blood well. […] When you have LN, your kidneys are not doing a good job removing waste from your blood or controlling the amount of fluids in your body. […] In its early stages, LN has very few signs of anything wrong. Some people have no specific symptoms. Kidney problems can start around the same time lupus symptoms appear and may include: Swelling in the hands, face, feet, belly, or around the eyes; Weight changes usually weight gain, but sometimes weight loss; Feeling very tired; Brown urine caused by blood; Foamy urine caused by protein; Urinating (peeing) less often than normal; High blood pressure. […] A key feature of LN is proteinuria, which is HIGH levels of protein in the urine. […] Without diagnosis and treatment, LN usually gets worse over time, which can lead to kidney failure. This serious condition occurs when almost all (over 90%) of your kidney function is lost. […] Up to 3 out of 10 people with lupus nephritis will develop kidney failure within 15 years of diagnosis.

• #17 Lupus nephritis | Kidney Care UK

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

  Many people with lupus nephritis have no specific symptoms until it is more severe. Damage to the kidneys will show on urine tests much earlier than in blood tests, so you should have regular urine tests as part of routine lupus check-ups so that it can be diagnosed and monitored as early as possible. Treating any kidney involvement early can help to prevent further damage, or the damage becoming more severe.

• #18 What Are the Symptoms of Lupus Nephritis?

  https://www.icliniq.com/articles/kidney-and-urologic-diseases/lupus-nephritis-symptoms-and-stages

  Lupus nephritis can get worse over time. Although you might not notice any symptoms in the beginning, it can eventually cause kidney damage. […] Understanding the symptoms of lupus nephritis and how the disease progresses through its different stages is essential for early diagnosis and better management. […] Understanding lupus nephritis symptoms early and recognizing how the disease progresses through its stages can help in timely diagnosis and management. Taking early action can slow down the kidney damage and thus improve overall health outcomes. […] Lupus nephritis symptoms can vary from person to person, but some of the most common symptoms of lupus nephritis include: Swelling (Edema): Noticeable swelling in the legs, feet, hands, and face due to fluid buildup. Foamy Urine: Caused by excess protein in the urine, a condition called proteinuria. High Blood Pressure: It can lead to high blood pressure as the kidneys struggle to function properly. Fatigue: Constant tiredness and weakness due to kidney dysfunction. Blood in Urine (Hematuria): Urine may appear pink, red, or cola-colored due to kidney inflammation. Weight Gain: Caused by fluid retention, leading to swelling in different body parts. Frequent Urination: Often occurs at night as the kidneys become less efficient at filtering waste.

• #19 What Are the Symptoms of Lupus Nephritis?

  https://www.icliniq.com/articles/kidney-and-urologic-diseases/lupus-nephritis-symptoms-and-stages

  Detecting lupus nephritis early can prevent severe kidney damage. Some early signs include: Mild swelling in the feet, ankles, or around the eyes. Slight changes in urine color or consistency, such as foamy or dark urine. A sudden rise in blood pressure. Increased fatigue and difficulty concentrating. Unexplained weight gain due to fluid retention. Discomfort in the lower back near the kidneys. […] Symptoms of lupus nephritis in different stages are as follows: Stage I (Minimal Change): No noticeable symptoms, and kidney function remains normal. Stage II (Mild Disease): Mild protein leakage in urine, slight swelling, and occasional high blood pressure. Stage III (Moderate Disease): Increased protein and blood in urine, moderate swelling, and higher blood pressure. Stage IV (Severe Disease): Significant protein loss, severe swelling, foamy urine, and kidney function decline. Stage V (Advanced Disease): Severe kidney dysfunction, high blood pressure, and risk of kidney failure. Stage VI (End-Stage Kidney Disease): Complete kidney failure requiring dialysis or a kidney transplant.

• #20 Lupus nephritis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lupus-nephritis/symptoms-causes/syc-20354335

  Lupus nephritis is a problem that occurs often in people who have systemic lupus erythematosus, also called lupus. […] 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. […] Signs and symptoms of lupus nephritis include: Blood in the urine. Urine that foams because of too much protein. High blood pressure. Swelling in the legs, ankles or feet and sometimes in the hands and face. High levels of a waste product called creatinine in the blood.

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• #22 Lupus Nephritis & Your Kidneys | National Kidney Foundation

  https://www.kidney.org/lupus-nephritis-your-kidneys

  Lupus nephritis is an inflammation of the kidneys caused by systemic lupus erythematosus (SLE). When you have lupus nephritis your kidneys are not doing a good job removing waste from your blood or controlling the amount of fluids in your body. […] Lupus nephritis usually gets worse over time, which can lead to kidney failure. […] Up to 3 out of 10 people with lupus nephritis will develop kidney failure within 15 years of diagnosis. […] A key feature of lupus nephritis is proteinuria, which means there are higher than normal levels of protein in the urine. […] In the early stages of lupus nephritis, there are very few signs that anything is wrong. In fact, some people have no specific symptoms. Kidney problems can start around the same time lupus symptoms appear and may include: foamy, bubbly or frothy urine, fatigue, inflammation or scarring of the kidneys, blood in the urine (hematuria), weight gain due to the fluid buildup in your body, swelling, usually in legs, feet or ankles, uncontrolled high blood pressure, which can lead to kidney damage.

• #23 Lupus nephritis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lupus-nephritis/symptoms-causes/syc-20354335

  Lupus nephritis is a problem that occurs often in people who have systemic lupus erythematosus, also called lupus. […] 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. […] Signs and symptoms of lupus nephritis include: Blood in the urine. Urine that foams because of too much protein. High blood pressure. Swelling in the legs, ankles or feet and sometimes in the hands and face. High levels of a waste product called creatinine in the blood.

• #24 Lupus nephritis: Stages and treatment options

  https://www.medicalnewstoday.com/articles/lupus-nephritis

  Lupus nephritis is a complication of systemic lupus erythematosus (SLE). It occurs when the immune system mistakenly attacks the kidneys, resulting in inflammation and organ damage. […] Without treatment, lupus nephritis can lead to permanent kidney damage and kidney failure. […] In the early stages of lupus nephritis, a person may not notice any symptoms. However, as the condition progresses it may cause the following symptoms: […] Blood in the urine: Also known as hematuria, this symptom occurs as damage to the glomeruli allows blood to leak into the urine, which may make it look pink or light brown. […] Protein in the urine: Also known as proteinuria, damage to the glomeruli can also result in protein leaking into urine. This may give urine a foamy appearance. […] High blood pressure: Also known as hypertension, damage to the glomeruli results in the kidneys being unable to remove waste and extra fluid. Having extra fluid in the blood vessels can increase blood pressure.

• #25 Lupus Nephritis | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/l/lupus-nephritis.html

  Lupus nephritis is an inflammation of the kidney caused by the rheumatic condition systemic lupus erythematosus (SLE). […] An estimated one-third of people with lupus will develop nephritis that requires medical evaluation and treatment. Lupus nephritis is a potentially serious symptom of lupus. […] Symptoms include: Weight gain, High blood pressure, Swelling around the eyes, legs, ankles or fingers. This is often the first noticeable symptom. The swelling is usually absent in the morning. It gradually gets worse as a person walks about during the day, Dark urine, Foamy, frothy urine and the need to get up to urinate during the night can suggest a loss of protein in the urine, In severe cases, kidney failure can occur. […] Even with treatment, some people with lupus nephritis continue to lose kidney function. In the event that both kidneys fail, it may be necessary to have dialysis. Ultimately, kidney transplantation may be needed.

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• #27 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. Symptoms can include fluid buildup in your body and increased urine output. About half of adults and 80% of children with lupus will develop lupus nephritis. […] Symptoms of lupus nephritis tend to develop about five years after lupus symptoms first appear. But lupus nephritis can be the first and sometimes the only manifestation of systemic lupus erythematosus (SLE). Lupus nephritis can cause: […] Edema (swelling due to fluid buildup) in your lower body or around your eyes. […] Increased urination, especially at night. […] Kidney failure develops in 10% to 30% of people with lupus nephritis. […] People who receive timely treatment for lupus nephritis have a positive outlook. […] Managing the condition with medication and diet changes may help delay or prevent kidney failure.

• #28 Lupus Nephritis

  https://www.meandmykidneys.com/en/home/people_like_me/people-like-me.html

  In 2006, Valerie was a vibrant freshman at the University of California, Santa Barbara, taking classes, working at the childrens center, joining several clubs, going to plays and concerts, and hanging out with friends. Then, she began feeling tired and had a persistent high fever. When her symptoms were at their worst, she could not walk down her hallway without feeling depleted. Then her urine changed to a dark brown, almost copper color, with white foam. She called her mother, a registered nurse, who told her to come home immediately. She was admitted to the hospital, and a kidney biopsy confirmed her doctors suspicions she had lupus nephritis. […] Lupus nephritis is a severe and potentially life-threatening manifestation of lupus resulting from kidney inflammation. Swelling around the eyes, legs, ankles, or fingers is often the first noticeable symptom. Severe cases can result in kidney failure. Approximately 60 percent of lupus patients will develop clinically relevant lupus nephritis, which is more likely to present severely in Asian Americans, African-Americans, and Latinos. […] For Valerie, the feeling of constant fatigue was one of the biggest challenges of her disease. […] Lupus has a reputation of being an unseen illness. You cant do something, but you arent outwardly showing symptoms, she says.

• #29 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 nephritis can cause permanent kidney damage, which is called chronic kidney disease, or CKD. The most serious type of lupus nephritis, proliferative nephritis, can cause scars to form in the kidneys. These scars damage the kidneys and keep them from working the way they should. Chronic kidney disease that gets worse and causes the kidneys to stop working is called kidney failure or end-stage renal disease (ESRD). Between 1 and 3 out of every 10 people with lupus nephritis eventually get kidney failure/ESRD. […] Talk to your health care provider about checking your kidney health if you have lupus and you notice any of the following symptoms: Weight gain, Fatigue, Joint pain, Joint swelling, Muscle pain, Unexplained fever, Red rash on your face, High blood pressure, Frequent urination, especially at night, Foamy or bubbly urine (a sign of protein in your urine), Blood in urine, Swelling in your legs, feet, ankles and sometimes your hands and face. […] Your health care providers may not always know if you have lupus nephritis right away. Symptoms of lupus nephritis can also look like symptoms of other diseases. It may take up to several years for you to get the right tests or diagnosis.

• #30 Lupus Nephritis – StatPearls – NCBI Bookshelf

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

  Lupus nephritis results from glomerular, tubulointerstitial, and vascular lesions. This condition typically affects 40% of patients with SLE, often within 5 years of diagnosis. Approximately 10% to 30% of patients with lupus nephritis will progress to ESRD within 10 years. […] Patients with lupus nephritis typically exhibit various clinical manifestations of SLE, including malar or discoid rash, fatigue, fever, photosensitivity, serositis, oral ulcers, nonerosive arthritis, seizures, psychosis, or hematologic disorders. In the early stages of lupus nephritis, patients are often asymptomatic. […] Early indications of proteinuria, reflecting tubular or glomerular dysfunction, include foamy urine or nocturia. When proteinuria meets the nephrotic syndrome threshold of more than 3.5 g/d, peripheral edema may occur due to hypoalbuminemia.

• #31 Systemic lupus erythematosus Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/systemic-lupus-erythematosus

  Symptoms vary from person to person, and may come and go. Everyone with SLE has joint pain and swelling at some time. Some develop arthritis. SLE often affects the joints of the fingers, hands, wrists, and knees. […] Other common symptoms include: Chest pain when taking a deep breath. Fatigue. Fever with no other cause. General discomfort, uneasiness

• #32 Lupus: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/4875-lupus

  Lupus causes symptoms throughout your body, depending on which organs or systems it affects. Everyone experiences a different combination and severity of symptoms. […] Lupus symptoms usually come and go in waves called flare-ups. During a flare-up, the symptoms can be severe enough to affect your daily routine. You might also have periods of remission when you have mild or no symptoms. […] Symptoms usually develop slowly. You might notice one or two signs of lupus at first, and then more or different symptoms later on. The most common symptoms include: Joint pain, muscle pain or chest pain (especially when you’re taking a deep breath). Headaches. Rashes (it’s common to have a rash across your face that providers sometimes call a butterfly rash). Fever. Hair loss. Mouth sores. Fatigue (feeling tired all the time). Shortness of breath (dyspnea). Swollen glands. Swelling in your arms, legs or on your face. Confusion. Blood clots.

• #33 What Are the Symptoms of Lupus Nephritis?

  https://www.icliniq.com/articles/kidney-and-urologic-diseases/lupus-nephritis-symptoms-and-stages

  Detecting lupus nephritis early can prevent severe kidney damage. Some early signs include: Mild swelling in the feet, ankles, or around the eyes. Slight changes in urine color or consistency, such as foamy or dark urine. A sudden rise in blood pressure. Increased fatigue and difficulty concentrating. Unexplained weight gain due to fluid retention. Discomfort in the lower back near the kidneys. […] Symptoms of lupus nephritis in different stages are as follows: Stage I (Minimal Change): No noticeable symptoms, and kidney function remains normal. Stage II (Mild Disease): Mild protein leakage in urine, slight swelling, and occasional high blood pressure. Stage III (Moderate Disease): Increased protein and blood in urine, moderate swelling, and higher blood pressure. Stage IV (Severe Disease): Significant protein loss, severe swelling, foamy urine, and kidney function decline. Stage V (Advanced Disease): Severe kidney dysfunction, high blood pressure, and risk of kidney failure. Stage VI (End-Stage Kidney Disease): Complete kidney failure requiring dialysis or a kidney transplant.

• #34 Lupus Nephritis & Your Kidneys | National Kidney Foundation

  https://www.kidney.org/lupus-nephritis-your-kidneys

  Some signs and symptoms associated with the different classes of lupus nephritis can be found in the table below. […] Signs and Symptoms: High blood pressure, dialysis may be needed as kidney function worsens. […] Signs and Symptoms: Blood and/or excess protein in urine and possible high blood pressure; dialysis or a kidney transplant may be needed. […] Signs and Symptoms: Dialysis or a kidney transplant may be needed.

• #35 What Are the Symptoms of Lupus Nephritis?

  https://www.icliniq.com/articles/kidney-and-urologic-diseases/lupus-nephritis-symptoms-and-stages

  Recognizing lupus nephritis early can help prevent irreversible kidney damage. Key warning signs of lupus nephritis kidney damage include Persistent swelling and fatigue in lupus nephritis include the hands, feet, or around the eyes. Blood or protein in urine. Elevated blood pressure. Extreme fatigue and difficulty concentrating. Persistent nausea or loss of appetite. Decreased urine output or difficulty urinating. […] Without proper treatment, lupus nephritis can quickly progress from mild kidney involvement to severe kidney failure. Medical intervention with early diagnosis needs to occur because it helps control this degenerative process. […] The stages of lupus nephritis progression include: Stage I (Minimal Mesangial Lupus Nephritis): No visible symptoms; minor kidney inflammation. Stage II (Mesangial Proliferative Lupus Nephritis): Mild inflammation; small amounts of protein in urine. Stage III (Focal Lupus Nephritis): Moderate kidney damage; blood and protein in the urine. Stage IV (Diffuse Lupus Nephritis): Severe inflammation and scarring; kidney function declines significantly. Stage V (Membranous Lupus Nephritis): High protein loss; increased risk of kidney failure. Stage VI (Advanced Sclerosing Lupus Nephritis): End-stage kidney disease; dialysis or transplant required.

• #36 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). […] When glomeruli and mesangial cells become damaged, the kidneys cannot properly remove waste and excess fluid from the blood. As a result, important components like protein and blood cells, which should remain in the body, can be lost in the urine. This can lead to symptoms of lupus nephritis, including: […] Symptoms of class 6 lupus nephritis include all of the symptoms associated with lupus nephritis and symptoms of ESRD, such as nausea, vomiting, fatigue, chest pain, shortness of breath, generalized swelling of the body, cramps, and itching.

• #37 Lupus nephritis Information | Mount Sinai – New York

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

  Lupus nephritis, which is a kidney disorder, is a complication of systemic lupus erythematosus. […] Symptoms of lupus nephritis include: Blood in the urine, Foamy appearance to urine, Swelling (edema) of any area of the body, High blood pressure. […] How well you do depends on the specific form of lupus nephritis. You may have flare-ups, and then times when you do not have any symptoms. Some people with this condition develop long-term (chronic) kidney failure. Although lupus nephritis may return in a transplanted kidney, it rarely leads to end-stage kidney disease.

• #38 Lupus and kidney disease (lupus nephritis) – Symptoms, treatment, & stages | National Kidney Foundation

  https://www.kidney.org/kidney-topics/lupus-nephritis

  Lupus nephritis is a disease that affects the kidneys, making it difficult for them to clean blood well. […] When you have LN, your kidneys are not doing a good job removing waste from your blood or controlling the amount of fluids in your body. […] In its early stages, LN has very few signs of anything wrong. Some people have no specific symptoms. Kidney problems can start around the same time lupus symptoms appear and may include: Swelling in the hands, face, feet, belly, or around the eyes; Weight changes usually weight gain, but sometimes weight loss; Feeling very tired; Brown urine caused by blood; Foamy urine caused by protein; Urinating (peeing) less often than normal; High blood pressure. […] A key feature of LN is proteinuria, which is HIGH levels of protein in the urine. […] Without diagnosis and treatment, LN usually gets worse over time, which can lead to kidney failure. This serious condition occurs when almost all (over 90%) of your kidney function is lost. […] Up to 3 out of 10 people with lupus nephritis will develop kidney failure within 15 years of diagnosis.

• #39 Consequences of Disease Progression in Lupus Nephritis

  https://www.ajmc.com/view/consequences-of-disease-progression-in-lupus-nephritis

  The way we monitor patients with lupus nephritis is by following certain markers to make sure theyre not progressing to more kidney damage and, if were treating them, making sure theyre responding to treatment. […] If patients arent being treated or diagnosed, they can progress to worsening kidney dysfunction because the kidney is undergoing constant attack by inflammatory cells and substances that can eventually lead to a scarred kidney. About 10% to 15% of patients with lupus nephritis can progress to end-stage kidney disease requiring renal replacement therapy, whether this is dialysis or kidney transplant. […] The faster you can treat lupus nephritis, the less likely you are to develop these irreversible changes. Once those irreversible changes develop, even if you shut off the autoimmune part of the disease, the impairment of kidney function may continue so that you may eventually develop end-stage kidney disease, or kidney failure, and require dialysis or a kidney transplant.

• #40 Consequences of Disease Progression in Lupus Nephritis

  https://www.ajmc.com/view/consequences-of-disease-progression-in-lupus-nephritis

  If you have lupus nephritis and its untreated, that inflammation continues and more immune complexes are deposited. That causes changes in the kidney tissue and function so that wastes arent cleared as well and protein continues to be spilled. […] One thing we definitely know about lupus nephritis is that the earlier you diagnose it and the more successfully you can treat it, the less likely you are to have these irreversible damages to the kidneys that can lead to kidney failure and the need for dialysis or transplantation.

• #41 Lupus nephritis – Wikipedia

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

  Lupus nephritis is an inflammation of the kidneys caused by systemic lupus erythematosus (SLE) […] In lupus nephritis, common symptoms of lupus such as fever, joint pain, muscle pain, and a butterfly-shaped rash on the face may be seen. Early kidney involvement might not cause any noticeable symptoms. As the condition progresses, signs may include frequent urination, needing to pass urine at night, foamy urine, high blood pressure, and edema. […] In those who have SLE, concomitant lupus nephritis is associated with a worse overall prognosis. 10-30% of people with lupus nephritis progress to kidney failure requiring dialysis, with the 5 year mortality rate of lupus nephritis being 5-25%. The proliferative forms of lupus nephritis are associated with a higher risk of progression to end stage kidney disease. Black and Hispanic people with lupus nephritis are more likely to present with severe disease at initial presentation (with more proteinuria and more extensive histopathologic changes) and progress to end stage kidney disease. This is thought to be due to socioeconomic factors but auto-antibodies strongly associated with lupus nephritis such as anti-Sm, anti-Ro and anti-ribonucleoprotein are also more commonly seen in Black and Hispanic people. Men with SLE tend to have more aggressive forms of lupus nephritis as well with a higher risk of progression to end stage kidney disease and higher risk of concurrent cardiovascular disease.

• #42 Factors Associated With Rapid Progression to Endstage Kidney Disease in Lupus Nephritis | The Journal of Rheumatology

  https://www.jrheum.org/content/48/2/228

  Lupus nephritis (LN) may lead to endstage kidney disease (ESKD) in 22% of patients over a period of 15 years, with the risk being particularly higher in diffuse proliferative forms. […] The rate of kidney function decline varies. However, a catastrophic course leading to ESKD within a few years from onset is uncommon. […] Ten patients (1.8% of the total LN population) developed ESKD within 3 years of diagnosis. Their mean age was 34.2 7.3 years, mean time to ESKD 19.2 12.4 months, initial eGFR 90.2 24.9 mL/min/1.73 m2, proteinuria 2.7 1.04 g/24 h. The median rate of kidney function decline was 43 mL/min/1.73 m2/year. […] Catastrophic progression to ESKD is uncommon in LN. The major associated factors are poor compliance and distinct histopathologic features such as thrombotic microangiopathy, collapsing glomerulopathy, and concomitant anti-GBM nephropathy.

• #43 Factors Associated With Rapid Progression to Endstage Kidney Disease in Lupus Nephritis | The Journal of Rheumatology

  https://www.jrheum.org/content/48/2/228

  A catastrophic course to ESKD, however, is rather uncommon. This study demonstrates that certain histopathological features and poor compliance are the main associated factors. […] Poor compliance was another factor to complicate patients with rapid progression to ESKD. […] In conclusion, catastrophic progression to ESKD within 3 years of diagnosis is uncommon in LN. The major potentially associated factors are distinct histopathologic features such as CG, anti-GBM antibodies, TMA, and severe interstitial inflammation. Poor compliance was also an aggravating factor in certain cases. Recognition of these features may stratify prognosis in the clinical setting and guide decisions for early intervention.

• #44 Lupus Nephritis – StatPearls – NCBI Bookshelf

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

  The treatment of lupus nephritis is primarily guided by histopathological class. All patients should initiate therapy with hydroxychloroquine at baseline unless contraindicated, with regular ophthalmological exams to assess for retinal toxicity. […] Immunosuppressive therapy and steroids are necessary for classes III and IV, while renal replacement therapy is considered for class VI, where most glomeruli are sclerotic. Active disease generally predicts a better response to treatment than chronic disease. […] Although lupus nephritis is associated with morbidity and mortality, the prognosis largely depends on the WHO histopathology classification. Classes I (minimal) and II (proliferative mesangial) generally have a favorable long-term prognosis. However, as lupus nephritis progresses to higher classes, the prognosis worsens. Class III has a poor prognosis, while class IV has the worst outcome. Early initiation of therapy is crucial starting treatment earlier in the disease course typically results in better outcomes.

• #45 Disease Progression of LN from SLE

  https://www.ajmc.com/view/disease-progression-of-ln-from-sle

  With respect to a renal flare, we recognize that a single episode of lupus nephritis can lead to irreversible and permanent damage of nephron loss. Subsequent renal insults lead to end-stage nephron survival and the need of renal replacement therapy. This has shown that lupus flare-ups and nephritis worsen the outcome of the patients end-stage renal disease and increase the patients morbidity and mortality. Ultimately, patient survival is decreased and death ensues. […] We have to be vigilant to the end-organ target damage, which tends to be unpredictable with autoimmune disease. Potential nephron and human demise is what were dealing with. Thats where the urgency in the management and aggressive interventions of this disease takes place. Unfortunately, the screening surveillance has statistically shown to be quite poorin particular the lack of academic guidance, socioeconomic status of the patients, and compliance at a very young age. The unpredictable behavior going from subtle to aggressive deterioration is all based on the histologic stages of this disease.

• #46 Disease Progression of LN from SLE

  https://www.ajmc.com/view/disease-progression-of-ln-from-sle

  With respect to the renal flare-ups, in addition to the above, we combine patient clinical presentations and findings, laboratory disease serology, urinary sediments, and renal markers to help assist in recognizing the flare-ups of these patients. In particular, hematuria, dysmorphic RBCs [red blood cells], CAS formations, proteinuria, urine PCR [protein-creatinine ratio], and serum creatinine all get taken into [consideration] in sequential fashion, along with the patients clinical findings and complaints and the serology activity of lupus nephritis. Depending on the degree of nephritis or nephrosis components, the serum creatinine behavior can predict the histologic stage, along with proteinuria and RBCs recognizing the potential of all those high-risk patients, which will lead us to the guidance of a renal biopsy, of which indications have changed over the years. With a renal biopsy, histologic tissue is of major importance in the diagnosis, prognosis, and therapeutic intervention.

• #47 Lupus and kidney disease (lupus nephritis) – Symptoms, treatment, & stages | National Kidney Foundation

  https://www.kidney.org/kidney-topics/lupus-nephritis

  Lupus nephritis is a disease that affects the kidneys, making it difficult for them to clean blood well. […] When you have LN, your kidneys are not doing a good job removing waste from your blood or controlling the amount of fluids in your body. […] In its early stages, LN has very few signs of anything wrong. Some people have no specific symptoms. Kidney problems can start around the same time lupus symptoms appear and may include: Swelling in the hands, face, feet, belly, or around the eyes; Weight changes usually weight gain, but sometimes weight loss; Feeling very tired; Brown urine caused by blood; Foamy urine caused by protein; Urinating (peeing) less often than normal; High blood pressure. […] A key feature of LN is proteinuria, which is HIGH levels of protein in the urine. […] Without diagnosis and treatment, LN usually gets worse over time, which can lead to kidney failure. This serious condition occurs when almost all (over 90%) of your kidney function is lost. […] Up to 3 out of 10 people with lupus nephritis will develop kidney failure within 15 years of diagnosis.

• #48 Lupus Nephritis – StatPearls – NCBI Bookshelf

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

  Lupus nephritis results from glomerular, tubulointerstitial, and vascular lesions. This condition typically affects 40% of patients with SLE, often within 5 years of diagnosis. Approximately 10% to 30% of patients with lupus nephritis will progress to ESRD within 10 years. […] Patients with lupus nephritis typically exhibit various clinical manifestations of SLE, including malar or discoid rash, fatigue, fever, photosensitivity, serositis, oral ulcers, nonerosive arthritis, seizures, psychosis, or hematologic disorders. In the early stages of lupus nephritis, patients are often asymptomatic. […] Early indications of proteinuria, reflecting tubular or glomerular dysfunction, include foamy urine or nocturia. When proteinuria meets the nephrotic syndrome threshold of more than 3.5 g/d, peripheral edema may occur due to hypoalbuminemia.

• #49 Lupus Nephritis – StatPearls – NCBI Bookshelf

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

  The treatment of lupus nephritis is primarily guided by histopathological class. All patients should initiate therapy with hydroxychloroquine at baseline unless contraindicated, with regular ophthalmological exams to assess for retinal toxicity. […] Immunosuppressive therapy and steroids are necessary for classes III and IV, while renal replacement therapy is considered for class VI, where most glomeruli are sclerotic. Active disease generally predicts a better response to treatment than chronic disease. […] Although lupus nephritis is associated with morbidity and mortality, the prognosis largely depends on the WHO histopathology classification. Classes I (minimal) and II (proliferative mesangial) generally have a favorable long-term prognosis. However, as lupus nephritis progresses to higher classes, the prognosis worsens. Class III has a poor prognosis, while class IV has the worst outcome. Early initiation of therapy is crucial starting treatment earlier in the disease course typically results in better outcomes.

• #50 Disease Progression of LN from SLE

  https://www.ajmc.com/view/disease-progression-of-ln-from-sle

  Lupus can affect many aspects of the body, including the scalp, skin, kidneys, heart, and lungs. Some patients have kidney involvement at the time of diagnosis of lupus. One way we tell is by doing a blood test to look for elevation of the creatinine, and then we do a urine test to look for protein in the urine, or proteinuria. The data show that of every 3 patients with lupus who present for the first time to a rheumatology clinic, 1 will have lupus nephritis. That triggers us to start aggressive therapy so that we dont let that patient progress to end-stage renal disease, which essentially means dialysis. Unfortunately, if patients have lupus nephritis, theyre 45 times more likely to get kidney disease than a patient without lupus nephritis. Thats a bad sign. […] With respect to the progressive nature of lupus nephritis over time, the disease tends to progress to transplant and dialysis. Depending on what you read, between 45% and 55% of patients with SLE [systemic lupus erythematosus] develop lupus nephritis. There are multiple histologic phases of lupus nephritis. Some remain stagnant, and others proceed in aggressive fashion to end-stage renal disease. Seventy percent of patients with lupus nephritis have stage III, IV, or V [disease], which tend to be the most aggressive [stages] with respect to the early intervention and management of the disease state. It can fluctuate. Many years in the past, we probably werent as aggressive with stage III. But now we recognize that the fluctuations and aggressiveness of the insult of the autoimmune disease can lead to significant deposition and rapid progression to the end stage, causing renal demise and ultimately patient survival and death.

• #51 Factors Associated With Rapid Progression to Endstage Kidney Disease in Lupus Nephritis | The Journal of Rheumatology

  https://www.jrheum.org/content/48/2/228

  Lupus nephritis (LN) may lead to endstage kidney disease (ESKD) in 22% of patients over a period of 15 years, with the risk being particularly higher in diffuse proliferative forms. […] The rate of kidney function decline varies. However, a catastrophic course leading to ESKD within a few years from onset is uncommon. […] Ten patients (1.8% of the total LN population) developed ESKD within 3 years of diagnosis. Their mean age was 34.2 7.3 years, mean time to ESKD 19.2 12.4 months, initial eGFR 90.2 24.9 mL/min/1.73 m2, proteinuria 2.7 1.04 g/24 h. The median rate of kidney function decline was 43 mL/min/1.73 m2/year. […] Catastrophic progression to ESKD is uncommon in LN. The major associated factors are poor compliance and distinct histopathologic features such as thrombotic microangiopathy, collapsing glomerulopathy, and concomitant anti-GBM nephropathy.

• #52 Lupus nephritis | Kidney Care UK

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

  Many people with lupus nephritis have no specific symptoms until it is more severe. Damage to the kidneys will show on urine tests much earlier than in blood tests, so you should have regular urine tests as part of routine lupus check-ups so that it can be diagnosed and monitored as early as possible. Treating any kidney involvement early can help to prevent further damage, or the damage becoming more severe.

• #53 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. Evaluating kidney function in SLE patients is important because early detection and treatment of kidney involvement can significantly improve renal outcome. […] Patients with lupus nephritis may report other symptoms of active SLE (eg, fatigue, fever, rash, arthritis, serositis, or central nervous system [CNS] disease); these are more common with focal (proliferative) and diffuse (proliferative) lupus nephritis. […] During regular follow-up, laboratory abnormalities suggesting active lupus nephritis include hematuria or proteinuria; this is more typical of mesangial or membranous lupus nephritis.

• #54 Lupus Nephritis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/25699

  A common and severe manifestation of SLE that requires evaluation is kidney involvement, referred to as „lupus nephritis.” Monitoring kidney function in patients with SLE is crucial, as early detection and management of renal impairment can significantly improve outcomes. Lupus nephritis typically develops 3 to 5 years after the onset of SLE. […] Monitoring for the development of lupus nephritis involves serial assessments of creatinine levels, urine protein-to-creatinine ratio, and urinalysis. These tests help detect increases in serum creatinine and the presence of proteinuria, which is commonly observed in lupus nephritis. Given the high risk of increased morbidity, timely treatment is crucial to prevent progression to end-stage renal disease (ESRD). […] 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. This process involves both intramolecular and intermolecular epitope spreading.

• #55 Peeing in a cup sucks

  https://www.getuncomfortable.com/

  Because the physical signs of lupus nephritis can be subtle, it’s crucial to stay on top of routine testing. […] They check for higher than normal levels of protein in the urine, known as proteinuria, which is a key sign of active lupus nephritis. […] Your doctor will likely aim for protein levels to stay below 0.5 grams (or 500 milligrams) per day. […] A KIDNEY BIOPSY confirms a lupus nephritis diagnosis, and can check the extent of kidney damage.

• #56 Symptoms Of Lupus Nephritis: Recognizing Early Warning Signs – Doral Health & Wellness NY

  https://doralhw.org/2024/01/19/symptoms-of-lupus-nephritis-recognizing-early-warning-signs/

  High blood pressure Lupus nephritis can lead to an elevated blood pressure […] Fatigue Feeling excessively tired or weak […] Joint pain Lupus can cause joint pain and stiffness […] Rashes Skin rashes are a common symptom in systemic lupus erythematosus […] Frequent infections Individuals may experience an increased susceptibility to infections. […] It is important to note that these symptoms can vary in severity, and not everyone with lupus nephritis may experience all of them. Early detection and management are very important to prevent complications and to preserve your kidney function. If you suspect you have lupus nephritis, seek medical attention for a proper diagnosis and treatment action plan. […] Early intervention Detecting lupus nephritis in its early stages will allow prompt medical intervention. Early treatment can also help manage your symptoms effectively and can potentially slow down the progression of possible kidney damage.

• #57 Symptoms Of Lupus Nephritis: Recognizing Early Warning Signs – Doral Health & Wellness NY

  https://doralhw.org/2024/01/19/symptoms-of-lupus-nephritis-recognizing-early-warning-signs/

  Preservation of kidney function Early detection and management of lupus nephritis can help preserve your kidney function. Early intervention can also prevent or minimize irreversible damage to your kidneys. […] Prevention of complications Lupus nephritis, when left untreated, can lead to several complications such as chronic kidney disease and in severe cases, kidney failure. Knowing how to identify the warning signs early can help prevent or lessen these complications. […] Improved quality of life Managing lupus nephritis early on can contribute to a better quality of life for people affected by these condition. […] Individualized treatment plans Early detection allows medical professionals to create treatment plans to your specific needs. This will also involve adjusting your medications, lifestyle changes, and close monitoring to improve outcomes.

• #58 Consequences of Disease Progression in Lupus Nephritis

  https://www.ajmc.com/view/consequences-of-disease-progression-in-lupus-nephritis

  If you have lupus nephritis and its untreated, that inflammation continues and more immune complexes are deposited. That causes changes in the kidney tissue and function so that wastes arent cleared as well and protein continues to be spilled. […] One thing we definitely know about lupus nephritis is that the earlier you diagnose it and the more successfully you can treat it, the less likely you are to have these irreversible damages to the kidneys that can lead to kidney failure and the need for dialysis or transplantation.

• #59 Lupus Nephritis – StatPearls – NCBI Bookshelf

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

  The treatment of lupus nephritis is primarily guided by histopathological class. All patients should initiate therapy with hydroxychloroquine at baseline unless contraindicated, with regular ophthalmological exams to assess for retinal toxicity. […] Immunosuppressive therapy and steroids are necessary for classes III and IV, while renal replacement therapy is considered for class VI, where most glomeruli are sclerotic. Active disease generally predicts a better response to treatment than chronic disease. […] Although lupus nephritis is associated with morbidity and mortality, the prognosis largely depends on the WHO histopathology classification. Classes I (minimal) and II (proliferative mesangial) generally have a favorable long-term prognosis. However, as lupus nephritis progresses to higher classes, the prognosis worsens. Class III has a poor prognosis, while class IV has the worst outcome. Early initiation of therapy is crucial starting treatment earlier in the disease course typically results in better outcomes.

• #60 Lupus Nephritis – StatPearls – NCBI Bookshelf

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

  The treatment of lupus nephritis is primarily guided by histopathological class. All patients should initiate therapy with hydroxychloroquine at baseline unless contraindicated, with regular ophthalmological exams to assess for retinal toxicity. […] Immunosuppressive therapy and steroids are necessary for classes III and IV, while renal replacement therapy is considered for class VI, where most glomeruli are sclerotic. Active disease generally predicts a better response to treatment than chronic disease. […] Although lupus nephritis is associated with morbidity and mortality, the prognosis largely depends on the WHO histopathology classification. Classes I (minimal) and II (proliferative mesangial) generally have a favorable long-term prognosis. However, as lupus nephritis progresses to higher classes, the prognosis worsens. Class III has a poor prognosis, while class IV has the worst outcome. Early initiation of therapy is crucial starting treatment earlier in the disease course typically results in better outcomes.

• #61 Lupus nephritis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000481.htm

  Lupus nephritis, which is a kidney disorder, is a complication of systemic lupus erythematosus. […] Symptoms of lupus nephritis include: Blood in the urine, Foamy appearance to urine, Swelling (edema) of any area of the body, High blood pressure. […] How well you do depends on the specific form of lupus nephritis. You may have flare-ups, and then times when you do not have any symptoms. Some people with this condition develop long-term (chronic) kidney failure. […] Complications that may result from lupus nephritis include: Acute renal failure, Chronic renal failure.

• #62 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). Clinical findings include hematuria, nephrotic-range proteinuria ( 3 g/day), and, in advanced stages, azotemia. […] The most prominent symptoms and signs are those of SLE; patients who present with kidney disease may have edema, hypertension, or a combination. […] 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.

• #63 Lupus Nephritis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/25699

  Lupus nephritis typically develops early in the disease course, most commonly in women between the ages of 20 and 40. […] Approximately 10% to 30% of patients with lupus nephritis will progress to ESRD within 10 years. […] Results from multiple lupus nephritis studies indicate that class IV is the most common form and is associated with the worst prognosis. […] Patients with lupus nephritis face a higher risk of atherosclerosis, with coronary artery disease (CAD) being the leading cause of mortality in individuals who have had SLE for more than 5 years. The increased CAD risk is strongly linked to lupus nephritis, with underlying mechanisms including atherosclerosis, vasculitis, thrombosis, embolization, and vasospasm. […] Although lupus nephritis is associated with morbidity and mortality, the prognosis largely depends on the WHO histopathology classification. Classes I (minimal) and II (proliferative mesangial) generally have a favorable long-term prognosis. However, as lupus nephritis progresses to higher classes, the prognosis worsens. Class III has a poor prognosis, while class IV has the worst outcome. Early initiation of therapy is crucialstarting treatment earlier in the disease course typically results in better outcomes.

• #64 Lupus Nephritis – StatPearls – NCBI Bookshelf

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

  The treatment of lupus nephritis is primarily guided by histopathological class. All patients should initiate therapy with hydroxychloroquine at baseline unless contraindicated, with regular ophthalmological exams to assess for retinal toxicity. […] Immunosuppressive therapy and steroids are necessary for classes III and IV, while renal replacement therapy is considered for class VI, where most glomeruli are sclerotic. Active disease generally predicts a better response to treatment than chronic disease. […] Although lupus nephritis is associated with morbidity and mortality, the prognosis largely depends on the WHO histopathology classification. Classes I (minimal) and II (proliferative mesangial) generally have a favorable long-term prognosis. However, as lupus nephritis progresses to higher classes, the prognosis worsens. Class III has a poor prognosis, while class IV has the worst outcome. Early initiation of therapy is crucial starting treatment earlier in the disease course typically results in better outcomes.

• #65 Lupus Nephritis Treatment in Delhi, India | Symptoms, Causes & Different Stages

  https://www.maxhealthcare.in/our-specialities/nephrology/conditions-treatments/lupus-nephritis

  If you are experiencing any of the symptoms listed above, it is important to consult with a doctor right away. Lupus nephritis is a serious condition, but it is treatable. With early diagnosis and treatment, most people with lupus nephritis can live long and healthy lives. […] Lupus nephritis can show up in various stages of severity. Determining the stages, therefore, is crucial as it helps guide treatment decisions and prognosis assessment. There are six recognized stages of lupus nephritis, each indicating different levels of kidney involvement and potential complications. The higher the stage of the disease, the more severe it is. […] People who are diagnosed with lupus nephritis early and receive prompt treatment have a good prognosis. Those who start taking medications, dialysis, or have a kidney transplant tend to do well. However, most people with lupus nephritis will need to manage their condition with medication or dialysis for the rest of their lives.

• #66 Lupus Nephritis Treatment in Delhi, India | Symptoms, Causes & Different Stages

  https://www.maxhealthcare.in/our-specialities/nephrology/conditions-treatments/lupus-nephritis

  With early diagnosis and treatment, most people with lupus nephritis can live long and healthy lives. Recent advances in treatment have greatly improved the prognosis for this condition. For example, as per The National Center for Biotechnology Informations report (updated July 2023), the 5-year survival rate is as high as 85% whereas the 10-year survival rate is 73%. […] There is currently no cure for lupus nephritis. However, treatment can help to manage the disease and prevent further kidney damage. Treatment options include medications, lifestyle changes, dialysis, and kidney transplant. […] There is no permanent cure for lupus nephritis. However, with early diagnosis and treatment, most people with lupus can live long and healthy lives.

• #67 Lupus Nephritis: Symptoms, Stages, and More

  https://www.healthline.com/health/lupus-nephritis

  Lupus nephritis may have similar symptoms to those of other kidney diseases. […] Symptoms may include: dark, foamy, or bloody urine, high blood pressure, weight gain, urinating often, especially at night, swelling in your feet, ankles, and legs. […] Speak with a doctor if you’re experiencing any of these symptoms, especially if you have foamy or bloody urine. […] Lupus nephritis symptoms may not appear immediately. However, early diagnosis is crucial to prevent kidney damage and failure, or even death. […] One of the first signs of lupus nephritis is bloody or foamy urine. […] Other signs and symptoms may include: urinating frequently, especially at night, swelling in the feet, ankles, and legs, high blood pressure, weight gain. […] With proper treatment and monitoring, most people with lupus nephritis won’t develop any complications. […] That said, 10-30% of people with lupus may have kidney failure. This happens when 85-90% of your kidneys stop working, and may be life-threatening. […] Early diagnosis and treatment are vital to help maintain kidney health.

• #68 Smith-specific regulatory T cells halt the progression of lupus nephritis | Nature Communications

  https://www.nature.com/articles/s41467-024-45056-x

  Antigen-specific regulatory T cells (Tregs) suppress pathogenic autoreactivity and are potential therapeutic candidates for autoimmune diseases such as systemic lupus erythematosus (SLE). […] Lupus nephritis (LN), a severe manifestation of SLE, is an important contributor to disease related morbidity and mortality. […] The presence of LN is strongly associated with autoreactivity to the Smith (Sm) autoantigen, which is in turn strongly associated with carriage of the human leukocyte antigen (HLA) haplotypes DRB1*15:01 (DR15) and DRB1*03:01. […] In LN, we identify Sm HLA-DR15 restricted CD4+ T-cell epitopes and highly reactive TCRs of the most immunogenic epitopes, create antigen-specific Tregs for the Sm autoantigen (Sm-Tregs), and evaluate the capacity of Sm-Tregs to suppress disease activity in vitro and in a humanized mouse model of lupus nephritis.

• #69 Smith-specific regulatory T cells halt the progression of lupus nephritis | Nature Communications

  https://www.nature.com/articles/s41467-024-45056-x

  Compared with polyclonal mock-transduced Tregs, Sm-Tregs potently suppress Sm-specific pro-inflammatory responses in vitro and suppress disease progression in a humanized mouse model of lupus nephritis. […] These results show that Sm-Tregs are a promising therapy for SLE. […] Sm-Tregs showed heightened inhibition of Sm-Tconv proliferation compared with mock Tregs and no Tregs. […] This indicates that Sm-Tregs are superior to polyclonal Tregs in their suppressive capacity of Sm-Tconvs, although the extent of allo-specific stimulation was unable to be assessed in this assay. […] Results from this experiment show that patient-derived Sm-Tregs suppressed disease activity significantly better than patient-derived polyclonal Tregs. […] At week 8, proteinuria continued to be mild in mice administered Sm-Tregs, whereas proteinuria severity had increased in mice administered polyclonal Tregs or no Tregs, indicating disease progression. […] The extent of kidney damage in periodic acid Schiff (PAS)-stained kidney sections reinforced the proteinuria findings; the percentage of necrotized glomeruli was significantly lower in mice administered Sm-Tregs than mice administered polyclonal Tregs or no Tregs.

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