Lupus Research Update – Kidney Lupus
Dr. Robert Katz shared this article with readers. Check lupusil.org for more “Latest News” for the lupus community
In an article from China about predictors of a treatment response in patients with active kidney lupus, a reduction in urine protein levels and improvement in blood albumin levels at the third month were valuable for predicting remission (an inactive period of the disease).
Lupus kidney disease can be divided into five major categories. Classes I and II are mild disease. Class III is where there is limited but definite inflammation seen on the kidney biopsy. Class IV disease on kidney biopsy is widespread inflammation (a lot of white blood cells) on the kidney biopsy. Class V is thickening of the membranes of the kidney, called membranous glomerulonephritis.
The glomerulus is the filter portion of the kidney. If it gets damaged, it is sort of like a coffee filter being disrupted so that coffee grounds will get into the liquid coffee. This damage to the glomerulus allows protein that should not be eliminated from the kidney to go through the kidney filter in large amounts. But as the kidney nephritis related to lupus is improved with treatment, the filter repairs itself, and there is much less protein drifting into the urine, and kidney function improves.
The study indicates that physicians treating patients for lupus nephritis (lupus affecting the kidneys) in any stage can use these tests to help determine treatment success and disease course.
Another article in the journal Lupus from Japan also looks at long-term mortality in patients with kidney lupus. They found that a complete response to therapy for active kidney disease was associated with much better longevity. Higher indices of lupus activity were a predictive value for failure to achieve a complete response to treatment.
Lupus kidney disease is one of the major clinical problems with systemic lupus. Lupus is systemic because it can involve many different organ systems including the kidneys. It is important to induce a remission and then with maintenance therapy continue to reduce the activity of glomerulonephritis (affecting the kidney filter-the glomerulus) with inflammation in kidney tissue.