Update on Lupus Nephritis: Core Curriculum 2020
Update on Lupus Nephritis: Core Curriculum 2020
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DOI：
10.1053/j.ajkd.2019.10.017
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发表时间：
2020-08-01
影响因子：
13.2
通讯作者：
Rovin, Brad H.
中科院分区：
文献类型：
--
作者：
Parikh, Samir, V;Almaani, Salem;Rovin, Brad H.
系统性红斑狼疮是一种多系统自身免疫性疾病，通常影响肾脏。狼疮性肾炎（LN）是系统性红斑狼疮肾脏损伤的最常见原因，也是发病率和死亡率的主要危险因素。LN的病理生理是不均匀的。遗传和环境因素可能导致这种异质性。尽管对LN的发病机制有了更好的了解，但治疗进展甚微，肾衰竭的风险仍然高得令人无法接受。本期《肾脏病学核心课程》提供了当前对LN流行病学、发病机制、诊断和治疗的最新了解。具有挑战性的问题，如妊娠期LN的管理，移植的时机，以及皮质类固醇在LN管理中不断发展的作用。我们回顾了目前接受的LN患者护理方法，并强调需要解决的缺陷，以更好地保持肾脏长期健康并改善LN的预后。
Systemic lupus erythematosus is a multisystem autoimmune disease that commonly affects the kidneys. Lupus nephritis (LN) is the most common cause of kidney injury in systemic lupus erythematosus and a major risk factor for morbidity and mortality. The pathophysiology of LN is heterogeneous. Genetic and environmental factors likely contribute to this heterogeneity. Despite improved understanding of the pathogenesis of LN, treatment advances have been few and risk for kidney failure remains unacceptably high. This installment in the Core Curriculum of Nephrology provides an up-to-date review of the current understanding of LN epidemiology, pathogenesis, diagnosis, and treatment. Challenging issues such as the management of LN in pregnancy, timing of transplantation, and the evolving role of corticosteroid use in the management of LN are discussed. We review the currently accepted approach to care for patients with LN and highlight deficiencies that need to be addressed to better preserve long-term kidney health and improve outcomes in LN.