Lupus Nephritis: Is the Kidney Biopsy Currently Necessary in the Management of Lupus Nephritis?
Lupus Nephritis: Is the Kidney Biopsy Currently Necessary in the Management of Lupus Nephritis?
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DOI：
10.2215/cjn.03400412
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发表时间：
2013-01-01
影响因子：
9.8
通讯作者：
Fogo, Agnes B.
中科院分区：
文献类型：
--
作者：
Giannico, Giovanna;Fogo, Agnes B.
大多数SLE患者发生与这种全身性基础疾病过程相关的肾脏疾病。狼疮性肾炎是系统性红斑狼疮患者发病甚至死亡的重要原因。狼疮性肾炎具有不同的形态学表现，具有不同的临床表现和后果。发病机制涉及免疫复合物，其可存款在肾脏的任何地方，以及其他机制，包括内皮损伤、足细胞病和肾小管间质损伤。因此，治疗和预后的范围从极好的，甚至只有最小的系膜沉积物的观察，肾衰竭，尽管积极的免疫抑制的患者严重的增殖性疾病。肾活检在狼疮性肾炎的诊断中起着至关重要的作用。然而，肾活检在预测预后、治疗和预后方面的作用一直存在争议。我们将回顾目前狼疮性肾炎的分类和肾活检的价值，在这些患者的管理。Clin J Am Soc Nephrol 8：138-145，2013. doi：10.2215/CJN.03400412
Most patients with SLE develop kidney disease related to this systemic underlying disease process. Lupus nephritis is an important cause of morbidity and even mortality in patients with systemic lupus erythematosus. Lupus nephritis has diverse morphologic manifestations with varying clinical presentations and consequences. The pathogeneses involve immune complexes, which can deposit anywhere in the kidney, and other mechanisms, including endothelial injury, podocytopathy, and tubulointerstitial injury. Treatment and prognosis accordingly range from excellent even with only observation with minimal mesangial deposits, to kidney failure despite aggressive immunosuppression in patients with severe proliferative disease. Renal biopsy plays a crucial role in the diagnosis of the specific form of lupus nephritis in any patient. However, the role of the renal biopsy in prediction of outcome, treatment, and prognosis has been controversial. We will review the current classification of lupus nephritis and the value of renal biopsy in the management of these patients. Clin J Am Soc Nephrol 8: 138-145, 2013. doi: 10.2215/CJN.03400412