Lupus nephritis: current update

Saxena et al. Arthritis Research & Therapy 2011, 13:240 http://arthritis-research.com/content/13/5/240 REVIEW Lupus nephritis: current update Ramesh...
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Saxena et al. Arthritis Research & Therapy 2011, 13:240 http://arthritis-research.com/content/13/5/240

REVIEW

Lupus nephritis: current update Ramesh Saxena*, Tina Mahajan and Chandra Mohan*

Abstract Lupus nephritis is a major cause of morbidity and mortality in patients with systemic lupus erythematosus. The general consensus is that 60% of lupus patients will develop clinically relevant nephritis at some time in the course of their illness. Prompt recognition and treatment of renal disease is important, as early response to therapy is correlated with better outcome. The present review summarizes our current understanding of the pathogenic mechanisms underlying lupus nephritis and how the disease is currently diagnosed and treated.

Introduction Lupus nephritis (LN) is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). The general consensus is that 60% of lupus patients will develop clinically relevant nephritis at some time in the course of their illness [1]. Prompt recognition and treatment of renal disease is important, as early response to therapy is correlated with better outcome [2]. The present review summarizes our current understanding of SLE pathogenesis, summarizes how the disease is diagnosed and treated, and expands on new emerging therapies. Epidemiology of lupus nephritis

Most SLE patients develop nephritis early in the course of their disease. The vast majority of patients who develop nephritis are younger than 55 years, and children are more likely to develop severe nephritis than are elderly patients [3]. In a recent retrospective study, male sex, young age (

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