Lupus nephritis is an inflammation of the kidney caused by systemic lupus erythematosus (SLE), a disease of the immune system. It is characterized by the deposition of many kinds of immune complexes in the glomeruli. It is also a progressive disease and is divided into four stages in clinic.
Stages of Lupus Nephritis
- Stage 1: Minimal mesangial inflammation
The glomeruli have a normal appearance under light microscopy, but mesangial deposits are visible under electron microscopy. At this stage, urinalysis is typically normal.
- Stage 2: Mesangial proliferative inflammation
It is noted by of mesangial cells proliferation and matrix expansion with deposition of immune complex. Microscopic hematuria with or without proteinuria may be seen. Hypertension, nephrotic syndrome, and acute renal insufficiency are rare at this stage.
- Stage 3: Focal lupus nephritis
This stage is indicated by sclerotic lesions involving less than 50% of the glomeruli, which can be segmental or global, and active or chronic, with endocapillary or extracapillary glomerulonephritis. Clinically, hematuria and proteinuria is present, with or without nephrotic syndrome, hypertension, and elevated serum creatinine. Stage 3 Lupus Nephritis is still the earliest stage of advanced lupus. Treatment requires high amounts of corticosteroids. The outlook remains favorable.
- Stage 4: Diffuse proliferative Lupus Nephritis
Stage 4 is both the most severe, and the most common type. More than 50% of glomeruli are involved. It is frequently with nephrotic syndrome, hypertension, hypocomplementemia, and elevated serum creatinine.
This stage is an advanced stage of lupus. There is the risk of kidney failure. Patients require high amounts of corticosteroids and immune suppression medications.
- Stage 5:
More than 90% of the glomeruli are injured. Patients experience excessive protein loss and swelling. Doctors will treat with high amounts of corticosteroids. Doctors may or may not give immune-suppressing drugs.
Treatment for Stage 3 Lupus Nephritis
There is no cure for Lupus Nephritis. The goal of treatment of stage 3 Lupus Nephritis is to prevent it progresses into stage 4 or stage 5. Immunotherapy is an effective way to treat Lupus Nephritis. It can not only improve immunity but also can enhance the renal self-curative ability so that the healthy renal intrinsic cells can be protected and the injured cells can be impaired. The deposition will disappear gradually.
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