Systemic lupus erythematosus (SLE) is an autoimmune disease with multisystem involvement and no cure. Among patients with SLE, roughly 50% develop lupus nephritis and are at risk of developing lupus nephritis-related end-stage kidney disease (ESKD). Current therapies for…
Our last post on lupus nephritis focused on pathogenesis ,clinical presentation, grading and class I/II disease. The next segment this month will cover class III-VI disease. Class III: Focal lupus nephritis It accounts for about 9-24% of lupus…
Lupus nephritis occurs in up to 80% of patients with SLE, and is associated with significantly reduced survival. Interestingly, one of the first studies to describe lupus nephritis was written approximately 50 years ago (Fig. 1) and was…
Time: 11:30 pm Place: Emergency Department (ED) of a public hospital in Mumbai (average attendance ~ 550 patients per day). A weary and teary mother wheels in her daughter ‘Asha’* who is in her early twenties. They have…
I recently finished my 2nd month on the consult service which was a very exciting time for me because I saw patients with every class of Lupus with different kinds of presentations. It was especially rewarding because I…
Rituximab, the monoclonal chimeric anti-CD20 antibody, is an effective B-Cell depleting agent and continues to gather data for its use in a wide range of conditions relevant for the Nephrologist. It was also a pre-season favourite in the…
It is well known that patients who are referred to see a nephrologist earlier in the course of their disease are more likely to start dialysis with a functioning fistula and have better overall survival relative to those…
Consider a patient with long-standing SLE who has biopsy proven WHO class IV lupus nephritis, previously treated with cyclophosphamide and steroids, which induced remission. Due to recurrence of proteinuria and desire to remain steroid-free, MMF was commenced with…
Many nephrologists will have faced “interesting specialty, shame about the evidence-base” jokes in the past. However, following a profusion of randomised controlled trials in lupus nephritis, we are now entering an era where we can integrate data to…
One of my patients has recently presented a treatment conundrum. She is a young woman with lupus that has required chronic low-dose steroids and mycofenolate mofetil at maximum dose to prevent relapse, a regimen she has been taking…
