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Renal Involvement in Systemic Lupus Erythematosus

Dr. Laurent ARNAUD @Lupusreference

#Renal #diseases #SLE #Systemic #Lupus #Erythematosus #venn #nephrology
Renal Involvement ... #diseases #SLE ... Erythematosus #venn #nephrology ... #nephritis #classification ... #types #rheumatology
Lupus Nephritis Classification Algorithm

#Lupus #Nephritis #Classification #Algorithm #diagnosis #differential #types #rheumatology #nephrology #renal
Lupus Nephritis Classification ... Lupus #Nephritis #Classification ... #Algorithm #diagnosis ... differential #types #rheumatology ... #nephrology #renal
Hematuria Workup and Diagnosis Algorithm
 • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup and Diagnosis ... nephrolithiasis • Symptoms ... → Refer to Nephrology ... for renal biopsy ... cystoscopy • Refer to Nephrology
Hematuria in Post-Renal Transplant Patient
Prevalence up to 12% in the postrenal transplant patient
 • Bacterial: Escherichia
Goodpasture's syndrome, SLE ... #differential #diagnosis ... kidney #blood #urine ... #management #treatment ... #nephrology
Distal Renal Tubular Acidosis (RTA)  Type 1 

Totally scuppers the kidney's acidification mechanism. Will be
Distal Renal Tubular ... much easier to diagnosis ... with direct urine ... Failure to acidify urine ... #Management #Nephrology
Hyperkalemic Distal Renal Tubular Acidosis (RTA) Type 4 - 

Failure to acidify urine in collecting duct
Hyperkalemic Distal Renal ... Failure to acidify urine ... #Hyperkalemic #Diagnosis ... #Management #Nephrology
Lupus Nephritis Primer
Class I - Minimal Mesangial
Class II - Mesangial Proliferative
Class Ill - Focal Proliferative
Class IV
Lupus #Nephritis #SLE ... #Classification ... #differential #diagnosis ... #management #nephrology
Management of Lupus Nephritis
Lupus nephritis (LN) in 10 to 40% of SLE
Hallmark = proteinuria 20.5 g/g
in 10 to 40% of SLE ... or 0.5 g/day → renal ... by 12 months Classification ... #rheumatology # ... nephrology
EULAR/ACR Classification Criteria for Systemic Lupus Erythematosus
Clinical Domains:
 • Constitutional domain: Fever
 • Cutaneous domain: Non-scarring
EULAR/ACR Classification ... pericarditis • Hematologic ... hemolysis • Renal ... #Criteria #SLE ... Erythematosus #diagnosis
Systemic Lupus Erythematosus - Summary
Antinuclear (ANA) - 95% - Initial screening test
Anti-dsDNA - 50%
 • Associated
severe disease & renal ... • Specific for SLE ... #Summary #diagnosis ... #rheumatology # ... management