15th July 2024

Background

Lupus nephritis is a severe manifestation seen in over 50% of patients with systemic lupus erythematosus (SLE) and is the main contributor to morbidity and mortality through its propensity to cause end-stage renal disease. The 2019 ACR and EULR classification criteria for SLE includes various features of renal involvement as its most heavily weighted diagnostic domain, in addition to a positive ANA titre of >1:80. The pathogenesis of lupus nephritis is complex with abnormalities in T-cell, B-cell and complement cascade pathways, but ultimately it is characterised by immune complex deposition in the glomeruli and inflammation throughout the kidneys.

Lupus nephritis has an affinity for young adults, particularly those of Asian and African American origin.  It is 12 times more likely to affect females than males.  Patients may present with a variety of symptoms depending on the class of disease.