Clinical presentation and monitoring of lupus nephritis
Clinical presentation and monitoring of lupus nephritis
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DOI：
10.1191/0961203305lu2055oa
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发表时间：
2005-01-01
期刊：
影响因子：
2.6
通讯作者：
Balow, JE
中科院分区：
文献类型：
--
作者：
Balow, JE
狼疮性肾炎临床表现的多样性与SLE患者肾脏病理损害的多样性相平行。肾脏表现包括无症状的血尿或蛋白尿到明显的肾炎和肾病综合征、快速进展的肾小球肾炎和慢性肾衰竭。由于在高通量临床病理学实验室进行的常规筛查尿分析的不可靠性，在疾病活动性的表现和监测期间的亚临床肾病经常被遗漏。对于有狼疮性肾炎风险的患者，应特别注意尿液显微镜检查。经典补体途径组分的抑制和抗DNA、抗核小体或抗C1q抗体的高滴度确定患者肾脏受累或肾炎发作的风险增加。有几种疾病活动和损伤指标可用，但它们大多用于临床研究环境，没有一种在标准临床实践中得到广泛使用。
The diversity of clinical presentations of lupus nephritis parallel the diversity of pathologic lesions seen in the kidneys of patients with SLE. Renal manifestations range from asymptomatic hematuria or proteinuria to overt nephritic and nephrotic syndromes, rapidly progressive glomerulonephritis, and chronic renal failure. Subclinical nephropathy both during presentation and during monitoring of disease activity is frequently missed because of the notorious unreliability of routine screening urinalyses performed in high-throughput clinical pathology laboratories. Requisitions for urine microscopy should be flagged for special attention in patients at risk for lupus nephritis. Depression of classic complement pathway components and high titers of anti-DNA, anti- nucleosome, or anti-C1q antibodies identify patients are increased risk of renal involvement or flares of nephritis. Several disease activity and damage indexes are available, but they are mostly used in clinical research setting and none has achieved wide use for standard clinical practice.