What is damaging the kidney in lupus nephritis? #MMPMID26581344
Davidson A
Nat Rev Rheumatol 2016[Mar]; 12 (3): 143-53 PMID26581344show ga
Despite marked improvements in the survival of patients with severe lupus nephritis over the last 50 years the rate of complete clinical remission following immune suppression is less than 50% and renal impairment still occurs in 40% of affected patients. An appreciation of factors leading to the development of chronic kidney disease (CKD) following acute or subacute renal injury in lupus patients is beginning to emerge. Processes that contribute to endstage renal injury include continuing inflammation, activation of intrinsic renal cells, cell stress and hypoxia, metabolic abnormalities, aberrant tissue repair and tissue fibrosis. This understanding is leading to the development of novel or adjunctive therapies that may protect from the secondary non-immune consequences of acute injury. Approaches based on a molecular/proteomic/lipidomic classification of disease should yield new information about the functional basis of disease heterogeneity so that the most effective and least toxic treatment regimens can be formulated for individual patients.
free
free
free
Nat+Rev+Rheumatol 2016 ; 12 (3): 143-53
