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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
Hyperkalemia: Diagnostic algorithm
Decreased renal potassium excretion
 • Acute renal failure
 • Chronic renal failure
 • Drugs
Increased
Hyperkalemia: Diagnostic ... failure • Chronic ... • Drugs • Diabetic ... Normal, Renin High ... Diagnosis #algorithm #nephrology
Renal Tubular Acidosis (RTA) 
Type 1 - Failure of secretion
Type 2 - Bicarbonate wasting
Type 4 -
Renal Tubular Acidosis ... Mixed* - Inherited carbonic ... proximal features and high ... #classification ... #nephrology #diagnosis
The Diagnostic Approach to Hyperkalemia
Drugs
 - Amiloride
 - Spironolactone
 - Triamterene
 - Trimethoprim
 - Pentamidine
 -
Diagnostic Approach to Hyperkalemia ... cell disease - Renal ... transplant - SLE ... High Renin - ... Low Renin - Diabetes
Causes of High-anion Gap and Non-anion Gap Metabolic Acidosis
Causes of High-anion Gap Acidosis:
 • Lactic acidosis
Causes of High-anion ... Acidosis Causes of High-anion ... Ketoacidosis: Diabetic ... Chronic progressive ... diagnosis #causes #nephrology
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
phlebotomy High ... (Uncontrolled diabetes ... insufficiency/Failure • SLE ... • Type IV RTA ... #nephrology
Classification of Diabetes Insipidus

Central or neurogenic diabetes insipidus:
 - Congenital - Structural malformations affecting the hypothalamus
Classification of ... Acquired - Primary renal ... , hypercalcemia) ... #Classification ... #Types #Nephrology
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
phlebotomy High ... (Uncontrolled diabetes ... insufficiency/Failure • SLE ... • Type IV RTA ... #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 ... severity (ISN/RPS classification ... by 12 months Classification ... #rheumatology #nephrology
Causes of Hyperkalemia
l. Pseudohyperkalemia
  A Cellular efflux; thrombocytosis, erythrocytosis, leukocytosis, in vitro hemolysis
  B.
diseases: syßtemic lupus ... erythematosus (SLE ... Diabetes, diabetic ... Differential #Diagnosis #High ... #Potassium #Classification