Abstract
In lupus erythematosus, elevated serum creatinine levels and urinary abnormalities implicate a kidney disorder, which may not always be lupus nephritis as defined by the current classification of the International Society of Nephrology/Renal Pathology Society. The signs of renal dysfunction may be caused by lupusunrelated renal injury such as drug toxicity or infection or by lupus-associated mechanisms that are not part of the classification, such as minimal change nephrotic syndrome or thrombotic microangiopathy. The latter seems to complicate lupus nephritis more frequently than previously thought. An unbiased assessment of kidney disease in lupus requires a kidney (re-)biopsy to define the appropriate management.
Highlights
In lupus erythematosus, elevated serum creatinine levels and urinary abnormalities implicate a kidney disorder, which may not always be lupus nephritis as defined by the current classification of the International Society of Nephrology/Renal Pathology Society
lupus erythematosus (LE) can manifest as cutaneous LE or as a systemic disorder [2]
How should lupus nephritis be defined? The current classification of the International Society of Nephrology/Renal Pathology Society (ISN/RPS) is based on the phenotype of immune complex glomerulonephritis that depends on the predominant site of immune complex deposition within the glomerulus and on different stages of acute
Summary
In lupus erythematosus, elevated serum creatinine levels and urinary abnormalities implicate a kidney disorder, which may not always be lupus nephritis as defined by the current classification of the International Society of Nephrology/Renal Pathology Society. In the previous issue of Arthritis Research & Therapy, Song and colleagues [1] discussed specific kidney abnormalities in patients with lupus erythematosus (LE). In patients with LE, renal abnormalities, such as elevated serum creatinine levels or urinary abnormalities, require further diagnostic work-up because they may indicate renal involvement in SLE or an unrelated form of renal disease [3].
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