Abstract
Nephritis in systemic lupus erythematosus represents the archetype of variable organ involvement of a disease. Our knowledge of the natural history of lupus nephritis has significantly improved in the last decade. There has been continuing refinement in histological classification, coupled with the recognition that the morphologically distinct glomerulopathies can have features of prognostic significance in common. Studies have demonstrated efficacy of immunosuppressive drugs in preserving renal function and reducing renal scarring, but consensus is lacking on the precise way in which the therapeutic regimes should be used. Most analyses have used either end-stage renal failure or death as a measure of outcome. Yet, the most common problems with which the clinician is faced are optimizing treatment of chronic, indolent or inactive disease whilst attempting to prevent the acute, possibly life-threatening flares of systemic lupus with nephritis. Recognition that acute deterioration in renal function in lupus nephritis is common proves the necessity for vigilance in management of each phase of the disease and indicates the need for a detailed, sensitive interpretation of the therapeutic needs of the individual patient.
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Ballardie, F.W. (1989). Lupus Nephritis. In: Catto, G.R.D. (eds) Multisystem Diseases. New Clinical Applications: Nephrology, vol 7. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-2223-5_3
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DOI: https://doi.org/10.1007/978-94-009-2223-5_3
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