Lupus nephritis and end-stage kidney disease

Am J Med Sci. 2013 Oct;346(4):319-23. doi: 10.1097/MAJ.0b013e31827f4ee3.


Systemic lupus erythematosus (SLE) is a multisystem disease affecting many organs. Varying degrees of renal involvement are seen in up to 60% of adults with SLE, and severe lupus nephritis (LN) (World Health Organization class III and above) progresses to end-stage kidney disease (ESKD) within 15 years of diagnosis in 10% to 30% of patients. In fact, renal injury is the most important predictor of mortality in patients with SLE. Identifying patients at risk of progression to ESKD and providing them with aggressive and appropriate immunosuppressive therapy are important factors that affect the morbidity and mortality of LN patients. Management of LN-related ESKD requires attention to persistent activity of SLE and need for continuous immunosuppressive treatment because a decrease in SLE activity in this population can improve their outcome.

Publication types

  • Review

MeSH terms

  • Disease Progression
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Kidney Failure, Chronic / epidemiology
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / physiopathology*
  • Kidney Failure, Chronic / therapy*
  • Kidney Transplantation
  • Lupus Nephritis / complications
  • Lupus Nephritis / epidemiology
  • Lupus Nephritis / physiopathology*
  • Lupus Nephritis / therapy*
  • Renal Dialysis
  • Risk Factors


  • Immunosuppressive Agents