Lupus nephritis

Renal compromise is frequent in patients with systemic lupus erythematosus (28%-74%), being it a factor associated to the highest morbimortality of the disease. The immune complexes deposit, complement activation, B and T lymphocytes and multiple cytokine, all take part in its pathogenesis. Clinical manifestations may include any renal syndrome, ranging from minimal alterations in urinary sediments to extreme chronic renal disease. Renal biopsy is indicated in all cases when renal damage is suspected, as well as upon clinical changes or changes in the evolution of patients diagnosed with lupus nephritis. Treatment is planned based on clinical presentation, predominant histological lesions, extra-renal compromise, age, comorbilities and patients' preferences. Some factors such as delay in diagnosis, age of disease onset, racial characteristics, forms of proliferation, levels of creatinine and proteinuria upon onset are associated to progression towards severe chronic kidney disease. The study reviews the main aspects related to epidemiology, clinical presentation, histological lesion and diagnostic and therapeutic strategies in lupus nephritis.