20Apr 2020

A REVIEW ON LUPUS NEPHRITIES: PATHOGENESIS, CLASSIFICATION, AND MANAGEMENT

Crossref Cited-by Linking logo
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Lupus nephritis is an autoimmune disease caused by systemic lupus erythematous, the prevalence of SLE and the chances of developing lupus nephritis (LN) vary considerably between different regions of the world and different races and ethnicities, a number of factors like genetic, environmental and immunology lead to inflammation of kidneys which is identified by biopsy, it is classified into six types based on the level of tissue damage and it is treated by induction, maintenance, adjuvant therapy and biological therapy. Mostly immunosuppressants, antimalarials are used.


  1. 1.Mumtaz Pate1, Alexandra M. Clarke,2Ian N. Bruce,2and Deborah P. M. Symmons2,The Prevalence and Incidence of Biopsy-Proven Lupus Nephritis in the UK, ARTHRITIS & RHEUMATISM Vol. 54, No. 9, September 2006, pp 2963?2969DOI 10.1002/art.22079? 2006, American College of Rheumatology.
  2. Melissa E. Munroe1 and Judith A. James1,2,*Genetics of Lupus Nephritis: Clinical Implications, Semin Nephrol. Author manuscript; available in PMC 2016 Sep 1.Published in final edited form as: Semin Nephrol. 2015 Sep; 35(5): 396?409. doi:?10.1016/j.semnephrol.2015.08.002 PMCID: PMC4653095 NIHMSID: NIHMS720613PMID: 26573543
  3. Brazilian Journal of Nephrology, Print?version?ISSN 0101-2800On-line?version?ISSN 2175-8239, J. Bras. Nefrol.?vol.41?no.2?S?o Paulo?Apr./June?2019 ?Epub?Nov?14, 2018 https://doi.org/10.1590/2175-8239-jbn-2018-0097
  4. Yujuan Liu Hans-Joachim Anders Nephrologisches Zentrum, Medizinische Klinik und Poliklinik IV, Klinikum der Universit?t, M?nchen, Munich , GermanyLupus Nephritis: From Pathogenesis to Targets for Biologic Treatment, Nephron Clin Pract 2014;128:224?231DOI: 10.1159/000368581
  5. Maciej Lech and Hans-Joachim AndersDepartment of Nephrology, Medical Clinic and Polyclinic IV, University of Munich, Munich, GermanyThe Pathogenesis of Lupus Nephritis j Am Soc Nephrol24:1357?1366, 2013 ISSN : 1046-6673/2409-1357
  6. Gabriella Moroni MD, etal :Anti-C1q antibodies may help in diagnosing a renal flare in lupus nephritis, American Journal of Kidney Diseases, Volume 37, Issue 3, March 2001, Pages 490-498
  7. WebMD Medical Reference Reviewed by David Zelman, MD on August 12, 2019
  8. Chi Chiu Mok : Understanding lupus nephritis: diagnosis, management, and treatment options, International Journal of Women's Health, Int J Womens Health. 2012; 4: 213?222. Published online 2012 May 22. doi:?10.2147/IJWH.S28034,PMCID: PMC3367406, PMID: 22675266
  9. CEDARS-SINAI, Lupus Nephritis, ? 2019 Cedars-Sinai. All Rights Reserved. A 501(c)(3) non-profit organization. www.cedars.sinai.edu
  10. webmed, labtest for lupus, www.webmed.com.
  11. Giovanna Giannico and Agnes B. Fogo, Lupus Nephritis: Is the Kidney Biopsy CurrentlyNecessary in the Management of Lupus Nephritis?, Copyright ? 2013 by the American Society of Nephrology, www.cjasn.org Vol 8 January, 2013
  12. Salem Almaani, Alexa Meara, and Brad H. Rovin, Glomerular DiseasesUpdate on Lupus Nephritis, clinical Journal of the American Society of Nephrology, CJASN.ePressPublished on November 7, 2016 as doi: 10.2215/CJN.05780616
  13. GS Markowitz1and VD DAgati11Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, New York, USA, The ISN/RPS 2003 classification of lupus nephritis:An assessment at 3 years, Kidney International(2007)71, 491?495, http://www.kidney-international.org
  14. JANJ. WEENING etal, The classification of glomerulonephritis in systemic lupuserythematosus revisited, Kidney International, Vol. 65 (2004), pp. 521?530
  15. Zachary Heeter, autoimmune Current Therapies for Lupus Nephritis, US pharmacist resource for excellence, Published June 20, 2012, www.uspharmacist.com
  16. Ajay Jaryal, Sanjay Vikrant : Department of Nephrology, Indira Gandhi Medical College (IGMC), Shimla, India, Current status of lupus nephritis, Indian journal of medical research, Year : 2017?/ Volume : 145 / Issue : 2/ Page : 167-178.
  17. Ioannou Y1, Isenberg DA, Current concepts for the management of systemic lupus erythematosus in adults: a therapeutic challenge. Postgrad Med J. 2002 Oct;78(924):599-606. www.ncbi.nlm.nih.gov
  18. Christian Burchardi; Detlef Schl?ndorff, Induction Therapy for Active Lupus Nephritis: Mycophenolate Mofetil Versus Cyclophosphamide, Nature Clinical Practice Nephrology, Nat Clin Pract Nephrol.?2006;2(6):314-315.
  19. 19.Chan TM1 Lupus nephritis: induction therapy,2005;14 Suppl 1:s27-32. PMID:? 15803928, DOI:10.1191/0961203305lu2114oa
  20. Lawrence H Brent, Arati S Karhadkar, Lupus Nephritis?Workup,Updated: Mar 04, 2019, www.medscape.com
  21. Saba Kiremitci * and Arzu EnsarClassifying Lupus Nephritis: An Ongoing StoryScientificWorldJournal. 2014; 2014: 580620, Published online 2014 Dec 8. doi:?10.1155/2014/580620, PMCID: PMC4274910, PMID: 25548784
  22. Rosalie M. Sterner,1,2 Stella P. Hartono,1,2 and Joseph P. Grande1,* The Pathogenesis of Lupus Nephritis, J Clin Cell Immunol. 2014 Apr; 5(2): 205. Published online 2014 Apr. doi:?10.4172/2155-9899.1000205
  23. Schwartzman-Morris J, Putterman C: Gender differences in the pathogenesis and outcome of lupus and of lupus nephritis. Clin Dev Immunol 2012: 604892, 2012
  24. Maciej Lech and Hans-Joachim Anders :The Pathogenesis of Lupus Nephritis, JASN September 2013, 24 (9) 1357-1366; DOI: https://doi.org/10.1681/ASN.2013010026
  25. Rebecca Wing-Yan Chan etal : Intrarenal cytokine gene expression in lupus nephritis,BMJ Annals of the Rheumatic Diseases http://dx.doi.org/10.1136/ard.2006.063123
  26. van Bruggen MC? etal:? Pathophysiology of lupus nephritis: the role of nucleosomes. The Netherlands Journal of Medicine, 01 Dec 1994, 45(6):273-279, PMID: 7838243
  27. Hans-Joachim Anders1 ,Brad Rovin2 :A pathophysiology-based approach to the diagnosis and treatment of lupus nephritis, ISN DOI: https://doi.org/10.1016/j.kint.2016.05.017
  28. Liu Y. ? Anders H.-J : Lupus Nephritis: From Pathogenesis to Targets for Biologic Treatment, Nephron Clin Pract 2014;128:224-231 https://doi.org/10.1159/000368581
  29. 29. Alberto de Zubiria Salgado1,2 and Catalina Herrera-Diaz2 : Lupus Nephritis: An Overview of Recent Findings, auto immune disease, Volume 2012 |Article ID 849684 | 21 pages | https://doi.org/10.1155/2012/849684
  30. Hahn BH, McMahon MA, Wilkinson A, et al. American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis. Arthritis Care Res. 2012;64:797-808
  31. Houssiau FA. Cyclophosphamide in lupus nephritis. Lupus. 2005;14:53-58
  32. Houssiau FA, Vasconcelos C, DCruz D, et al. Immunosuppressive therapy in lupus nephritis: the Euro-Lupus Nephritis Trial, a randomized trial of low-dose versus high-dose intravenous cyclophosphamide. Arthritis Rheum. 2002;46:2121-2131
  33. Austin HA 3rd, Ilei GG, Braun MJ, Ballow JE. Randomized, controlled trial of prednisone, cyclophosphamide, and cyclosporine in lupus membranous nephropathy. J Am Soc Nephrol. 2009;20:901-911.
  34. Radhakrishnan J, Moutzouris DA, Ginzler EM, et al. Mycophenolate mofetil and intravenous cyclophosphamide are similar as induction therapy for class V lupus nephritis. Kidney Int. 2010;77:152-160.
  35. Liu Z, Davidson A: Taming lupus-a new understanding of pathogenesis is leading to clinical advances. Nat Med 18: 871?882, 2012
  36. Saxena R, Mahajan T, Mohan C: Lupus nephritis: Current update. Arthritis Res Ther 13: 240, 2011
  37. Mu?oz LE, Lauber K, Schiller M, Manfredi AA, Herrmann M: The role of defective clearance of apoptotic cells in systemic autoimmunity. Nat Rev Rheumatol 6: 280?289, 2010
  38. Lande R, Ganguly D, Facchinetti V, Frasca L, Conrad C, Gregorio J, Meller S, Chamilos G, Sebasigari R, Riccieri V, Bassett R, Amuro H, Fukuhara S, Ito T, Liu YJ, Gilliet M: Neutrophils activate plasmacytoid dendritic cells by releasing self-DNA-peptide complexes in systemic lupus erythematosus. Sci Transl Med 3: 73ra19, 2011
  39. Caricchio R, McPhie L, Cohen PL: Ultraviolet B radiation-induced cell death: Critical role of ultraviolet dose in inflammation and lupus autoantigen redistribution. J Immunol 171: 5778?5786, 2003
  40. Yung S, Chan TM: Autoantibodies and resident renal cells in the pathogenesis of lupus nephritis: Getting to know the unknown. Clin Dev Immunol 2012: 139365, 2012
  41. Cameron JS: Systemic lupus erythematosus. In: Immunologic Renal Disease, edited by Nielson EG, Couser WG, Philadelphia, Lippincott-Raven, pp 1055-1094,1997
  42. Tan EM, Cohen AS, Fries JF: The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum25 : 1276-1282,1982
  43. Donadio JV, Glassock RJ: Immunosuppressive drug therapy in lupus nephritis. Am J Kidney Dis 21:239 -250, 1993
  44. Cameron JS: What is the role of long-term cytotoxic agents in the treatment of lupus nephritis? J Nephrol6 : 172-176,1993
  45. Ginzler E, Sharon E, Diamond H, Kaplan D: Long-term maintenance therapy with azathioprine in systemic lupus erythematosus. Arthritis Rheum 18: 27-34,1975
  46. Walport MJ: The pathogenesis of systemic lupus erythematosus. In:Oxford Textbook of Clinical Nephrology , 2nd Ed., edited by Davison AM, Cameron JS, Gr?nfeld J-P, Kerr DNS, Ritz E, Winearls CG, London, Oxford University Press, 1997, pp917 -935
  47. Elena V. Zakharova etal : Immunosuppressive Treatment for Lupus Nephritis, Volume 2016 |Article ID 7407919 | 7 pages | https://doi.org/10.1155/2016/7407919
  48. S. Koo, S. Kim, and H. J. Chin, ?Remission of proteinuria indicates good prognosis in patients with diffuse proliferative lupus nephritis,? Lupus, vol. 25, no. 1, pp. 3?11, 2016.
  49. Chan TM, Li FK, Tang CS, et al. Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis. N Engl J Med. 2000;343:1156-1162.
  50. Felson DT, Anderson J: Evidence for the superiority of immunosuppressive drugs and prednisone over prednisone alone in lupus nephritis. N Engl J Med 311:1528 -1533, 1984
  51. Boumpas DT, Austin HA III, Vaughan EM, Klippel JH, Steinberg AD, Yarboro CH, Balow JE: Controlled trial of pulse methylprednisolone versus two regimens of pulse cyclophosphamide in severe lupus nephritis.Lancet 340:741 -745, 1992
  52. Bansal VK, Beto JA: Treatment of lupus nephritis: A metaanalysis of clinical trials. Am J Kidney Dis 29:193 -199, 1997
  53. Parikh SV, Rovin BH. Current and Emerging Therapies for Lupus Nephritis. J Am Soc Nephrol 2016; 27:2929.
  54. Bomback AS, Appel GB. Updates on the treatment of lupus nephritis. J Am Soc Nephrol 2010; 21:2028.
  55. Richardson B, Scheinbart L, Strahler J, Gross L, Hanash S, Johnson M: Evidence for impaired T cell DNA methylation in systemic lupus erythematosus and rheumatoid arthritis. Arthritis Rheum 33: 1665?1673, 1990
  56. Cornacchia E, Golbus J, Maybaum J, Strahler J, Hanash S, Richardson B: Hydralazine and procainamide inhibit T cell DNA methylation and induce autoreactivity. J Immunol 140: 2197?2200, 1988
  57. Sis? A, Ramos-Casals M, Bov? A, Brito-Zer?n P, Soria N, Mu?oz S, et al. Previous antimalarial therapy in patients diagnosed with lupus nephritis: Influence on outcomes and survival. Lupus 2008; 17 : 281-8.
  58. Pons-Estel GJ, Alarc?n GS, McGwin G Jr., Danila MI, Zhang J, Bastian HM, et al. Protective effect of hydroxychloroquine on renal damage in patients with lupus nephritis: LXV, data from a multiethnic US cohort. Arthritis Rheum 2009; 61 : 830-9.
  59. Tse KC, Li FK, Tang S, Tang CS, Lai KN, Chan TM. Angiotensin inhibition or blockade for the treatment of patients with quiescent lupus nephritis and persistent proteinuria. Lupus 2005; 14 : 947-52.
  60. Kitamura N, Matsukawa Y, Takei M, Sawada S. Antiproteinuric effect of angiotensin-converting enzyme inhibitors and an angiotensin II receptor blocker in patients with lupus nephritis. J Int Med Res 2009; 37 : 892-8.
  61. Dur?n-Barrag?n S, McGwin G Jr., Vil? LM, Reveille JD, Alarc?n GS; LUMINA (LIX): A multiethnic US cohort. Angiotensin-converting enzyme inhibitors delay the occurrence of renal involvement and are associated with a decreased risk of disease activity in patients with systemic lupus erythematosus ? results from LUMINA (LIX): A multiethnic US cohort. Rheumatology (Oxford) 2008; 47 : 1093-6.
  62. Faul C, Donnelly M, Merscher-Gomez S, Chang YH, Franz S, Delfgaauw J, et al. The actin cytoskeleton of kidney podocytes is a direct target of the antiproteinuric effect of cyclosporine A. Nat Med 2008; 14 : 931-8
  63. Gordon S, Denunzio T, Uy A. Success using tacrolimus in patients with proliferative and membranous lupus nephritis and refractory proteinuria. Hawaii J Med Public Health 2013; 72 (9 Suppl 4) : 18-23.
  64. Merrill JT, Neuwelt CM, Wallace DJ, Shanahan JC, Latinis KM, Oates JC, et al. Efficacy and safety of rituximab in moderately-to-severely active systemic lupus erythematosus: The randomized, double-blind, phase II/III systemic lupus erythematosus evaluation of rituximab trial. Arthritis Rheum 2010; 62 : 222-33.
  65. Reddy V, Jayne D, Close D, Isenberg D. B-cell depletion in SLE: Clinical and trial experience with rituximab and ocrelizumab and implications for study design. Arthritis Res Ther 2013; 15 (Suppl 1) : S2.
  66. Wallace DJ, Kalunian K, Petri MA, Strand V, Houssiau FA, Pike M, et al. Efficacy and safety of epratuzumab in patients with moderate/severe active systemic lupus erythematosus: Results from EMBLEM, a phase IIb, randomised, double-blind, placebo-controlled, multicentre study. Ann Rheum Dis 2014; 73 : 183-90.
  67. Navarra SV, Guzm?n RM, Gallacher AE, Hall S, Levy RA, Jimenez RE, et al. Efficacy and safety of belimumab in patients with active systemic lupus erythematosus: A randomised, placebo-controlled, phase 3 trial. Lancet 2011; 377 : 721-31.
  68. Merrill JT, Burgos-Vargas R, Westhovens R, Chalmers A, D'Cruz D, Wallace DJ, et al. The efficacy and safety of abatacept in patients with non-life-threatening manifestations of systemic lupus erythematosus: Results of a twelve-month, multicenter, exploratory, phase IIb, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2010; 62 : 3077-87.
  69. Ginzler EM, Wax S, Rajeswaran A, Copt S, Hillson J, Ramos E, et al. Atacicept in combination with MMF and corticosteroids in lupus nephritis: Results of a prematurely terminated trial. Arthritis Res Ther 2012; 14 : R33.

[Balaga Rathnamala, K.Vishal, S.Salini and Enjum Nihith Chandra (2020); A REVIEW ON LUPUS NEPHRITIES: PATHOGENESIS, CLASSIFICATION, AND MANAGEMENT Int. J. of Adv. Res. 8 (Apr). 113-124] (ISSN 2320-5407). www.journalijar.com


BALAGA RATHNAMALA
HOLYMARY INSTITUTE OF TECHNOLOGY AND SCIENCE.

DOI:


Article DOI: 10.21474/IJAR01/10753      
DOI URL: http://dx.doi.org/10.21474/IJAR01/10753