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Lupus Nephritis

  • Kartik Pillutla
  • Kuang-Yu Jen
Chapter

Abstract

Lupus nephritis in the adolescent is a frequently severe disease with considerable risk for morbidity and mortality. With treatment advances, there has been improved renal and overall survival. However, relapses and other adverse events can be seen. Full diagnostic evaluation and classification of the disease is required to guide optimal treatment. Clinicians should be aware of the comorbidities associated with the disease process and prescribed pharmacotherapy as it can have significant medical and psychosocial effects on the adolescent.

Keywords

Lupus nephritis Adolescent Chronic kidney disease Childhood Systemic lupus erythematosus 

References

  1. 1.
    Levy DM, Kamphuis S. Systemic lupus erythematosus in children and adolescents. Pediatr Clin N Am. 2012;59(2):345–64.CrossRefGoogle Scholar
  2. 2.
    Anders HJ, Rovin B. A pathophysiology-based approach to the diagnosis and treatment of lupus nephritis. Kidney Int. 2016;90(3):493–501.CrossRefGoogle Scholar
  3. 3.
    Nowling TK, Gilkeson GS. Mechanisms of tissue injury in lupus nephritis. Arthritis Res Ther. 2011;13(6):250.CrossRefGoogle Scholar
  4. 4.
    Tarr T, Derfalvi B, Gyori N, Szanto A, Siminszky Z, Malik A, et al. Similarities and differences between pediatric and adult patients with systemic lupus erythematosus. Lupus. 2015;24(8):796–803.CrossRefGoogle Scholar
  5. 5.
    Hiraki LT, Feldman CH, Liu J, Alarcon GS, Fischer MA, Winkelmayer WC, et al. Prevalence, incidence, and demographics of systemic lupus erythematosus and lupus nephritis from 2000 to 2004 among children in the US Medicaid beneficiary population. Arthritis Rheum. 2012;64(8):2669–76.CrossRefGoogle Scholar
  6. 6.
    Livingston B, Bonner A, Pope J. Differences in clinical manifestations between childhood-onset lupus and adult-onset lupus: a meta-analysis. Lupus. 2011;20(13):1345–55.CrossRefGoogle Scholar
  7. 7.
    Tucker LB, Uribe AG, Fernandez M, Vila LM, McGwin G, Apte M, et al. Adolescent onset of lupus results in more aggressive disease and worse outcomes: results of a nested matched case-control study within LUMINA, a multiethnic US cohort (LUMINA LVII). Lupus. 2008;17(4):314–22.CrossRefGoogle Scholar
  8. 8.
    Mina R, von Scheven E, Ardoin SP, Eberhard BA, Punaro M, Ilowite N, et al. Consensus treatment plans for induction therapy of newly diagnosed proliferative lupus nephritis in juvenile systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2012;64(3):375–83.CrossRefGoogle Scholar
  9. 9.
    Almaani S, Meara A, Rovin BH. Update on lupus nephritis. Clin J Am Soc Nephrol. 2016.Google Scholar
  10. 10.
    Bastian HM, Roseman JM, McGwin G Jr, Alarcon GS, Friedman AW, Fessler BJ, et al. Systemic lupus erythematosus in three ethnic groups. XII. Risk factors for lupus nephritis after diagnosis. Lupus. 2002;11(3):152–60.CrossRefGoogle Scholar
  11. 11.
    Parikh SV, Rovin BH. Current and emerging therapies for lupus nephritis. J Am Soc Nephrol. 2016;27(10):2929–39.CrossRefGoogle Scholar
  12. 12.
    Vachvanichsanong P, McNeil E. Pediatric lupus nephritis: more options, more chances? Lupus. 2013;22(6):545–53.CrossRefGoogle Scholar
  13. 13.
    Balow JE. Clinical presentation and monitoring of lupus nephritis. Lupus. 2005;14(1):25–30.CrossRefGoogle Scholar
  14. 14.
    Hiraki LT, Benseler SM, Tyrrell PN, Hebert D, Harvey E, Silverman ED. Clinical and laboratory characteristics and long-term outcome of pediatric systemic lupus erythematosus: a longitudinal study. J Pediatr. 2008;152(4):550–6.CrossRefGoogle Scholar
  15. 15.
    Pereira T, Abitbol CL, Seeherunvong W, Katsoufis C, Chandar J, Freundlich M, et al. Three decades of progress in treating childhood-onset lupus nephritis. Clin J Am Soc Nephrol. 2011;6(9):2192–9.CrossRefGoogle Scholar
  16. 16.
    Ayalon R, Beck LH Jr. Membranous nephropathy: not just a disease for adults. Pediatr Nephrol. 2015;30(1):31–9.CrossRefGoogle Scholar
  17. 17.
    Hahn BH, McMahon MA, Wilkinson A, Wallace WD, Daikh DI, Fitzgerald JD, et al. American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis. Arthritis Care Res (Hoboken). 2012;64(6):797–808.CrossRefGoogle Scholar
  18. 18.
    Petri M, Orbai AM, Alarcon GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64(8):2677–86.CrossRefGoogle Scholar
  19. 19.
    Weening JJ, D’Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB, et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited. J Am Soc Nephrol. 2004;15(2):241–50.CrossRefGoogle Scholar
  20. 20.
    Corwin HL, Schwartz MM, Lewis EJ. The importance of sample size in the interpretation of the renal biopsy. Am J Nephrol. 1988;8(2):85–9.CrossRefGoogle Scholar
  21. 21.
    Rovin BH, Parikh SV, Alvarado A. The kidney biopsy in lupus nephritis: is it still relevant? Rheum Dis Clin N Am. 2014;40(3):537–52. ixCrossRefGoogle Scholar
  22. 22.
    Marks SD, Sebire NJ, Tullus K. Classification of pediatric lupus nephritis. Kidney Int. 2007;72(7):897–8.CrossRefGoogle Scholar
  23. 23.
    Michail S, Stathakis C, Marinaki S, Revenas C, Nakopoulou L, Vaiopoulos G. Relapse of predominant tubulointerstitial lupus nephritis. Lupus. 2003;12(9):728–9.CrossRefGoogle Scholar
  24. 24.
    Song D, Wu LH, Wang FM, Yang XW, Zhu D, Chen M, et al. The spectrum of renal thrombotic microangiopathy in lupus nephritis. Arthritis Res Ther. 2013;15(1):R12.CrossRefGoogle Scholar
  25. 25.
    Sun F, Wang X, Wu W, Wang K, Chen Z, Li T, et al. TMA secondary to SLE: rituximab improves overall but not renal survival. Clin Rheumatol. 2017;Google Scholar
  26. 26.
    Imran TF, Yick F, Verma S, Estiverne C, Ogbonnaya-Odor C, Thiruvarudsothy S, et al. Lupus nephritis: an update. Clin Exp Nephrol. 2016;20(1):1–13.CrossRefGoogle Scholar
  27. 27.
    Pons-Estel GJ, Alarcon GS, McGwin G Jr, Danila MI, Zhang J, Bastian HM, et al. Protective effect of hydroxychloroquine on renal damage in patients with lupus nephritis: LXV, data from a multiethnic US cohort. Arthritis Rheum. 2009;61(6):830–9.CrossRefGoogle Scholar
  28. 28.
    Griffin B, Lightstone L. Renoprotective strategies in lupus nephritis: beyond immunosuppression. Lupus. 2013;22(12):1267–73.CrossRefGoogle Scholar
  29. 29.
    Anders HJ, Vielhauer V. Renal co-morbidity in patients with rheumatic diseases. Arthritis Res Ther. 2011;13(3):222.CrossRefGoogle Scholar
  30. 30.
    Kidney Disease: Improving Global Outcomes (KDIGO) Glomerulonephritis Work Group. KDIGO clinical practice guideline for glomerulonephritis. Kidney Inter Suppl. 2012;2:139–274.Google Scholar
  31. 31.
    Couture J, Silverman ED. Update on the pathogenesis and treatment of childhood-onset systemic lupus erythematosus. Curr Opin Rheumatol. 2016;28(5):488–96.CrossRefGoogle Scholar
  32. 32.
    Korbet SM, Lewis EJ, Schwartz MM, Reichlin M, Evans J, Rohde RD. Factors predictive of outcome in severe lupus nephritis. Lupus Nephritis Collaborative Study Group. Am J Kidney Dis. 2000;35(5):904–14.CrossRefGoogle Scholar
  33. 33.
    Chen YE, Korbet SM, Katz RS, Schwartz MM, Lewis EJ, Collaborative Study G. Value of a complete or partial remission in severe lupus nephritis. Clin J Am Soc Nephrol. 2008;3(1):46–53.CrossRefGoogle Scholar
  34. 34.
    Lenz O, Waheed AA, Baig A, Pop A, Contreras G. Lupus nephritis: maintenance therapy for lupus nephritis – do we now have a plan? Clin J Am Soc Nephrol. 2013;8(1):162–71.CrossRefGoogle Scholar
  35. 35.
    Hogan J, Appel GB. Update on the treatment of lupus nephritis. Curr Opin Nephrol Hypertens. 2013;22(2):224–30.CrossRefGoogle Scholar
  36. 36.
    Sundel R, Solomons N, Lisk L, Aspreva Lupus Management Study G. Efficacy of mycophenolate mofetil in adolescent patients with lupus nephritis: evidence from a two-phase, prospective randomized trial. Lupus. 2012;21(13):1433–43.CrossRefGoogle Scholar
  37. 37.
    Isenberg D, Appel GB, Contreras G, Dooley MA, Ginzler EM, Jayne D, et al. Influence of race/ethnicity on response to lupus nephritis treatment: the ALMS study. Rheumatology (Oxford). 2010;49(1):128–40.CrossRefGoogle Scholar
  38. 38.
    Dooley MA, Jayne D, Ginzler EM, Isenberg D, Olsen NJ, Wofsy D, et al. Mycophenolate versus azathioprine as maintenance therapy for lupus nephritis. N Engl J Med. 2011;365(20):1886–95.CrossRefGoogle Scholar
  39. 39.
    Rovin BH, Furie R, Latinis K, Looney RJ, Fervenza FC, Sanchez-Guerrero J, et al. Efficacy and safety of rituximab in patients with active proliferative lupus nephritis: the lupus nephritis assessment with rituximab study. Arthritis Rheum. 2012;64(4):1215–26.CrossRefGoogle Scholar
  40. 40.
    Cortes-Hernandez J, Torres-Salido MT, Medrano AS, Tarres MV, Ordi-Ros J. Long-term outcomes – mycophenolate mofetil treatment for lupus nephritis with addition of tacrolimus for resistant cases. Nephrol Dial Transplant. 2010;25(12):3939–48.CrossRefGoogle Scholar
  41. 41.
    Ward F, Bargman JM. Membranous lupus nephritis: the same, but different. Am J Kidney Dis. 2016;68(6):954–66.CrossRefGoogle Scholar
  42. 42.
    Swan JT, Riche DM, Riche KD, Majithia V. Systematic review and meta-analysis of immunosuppressant therapy clinical trials in membranous lupus nephritis. J Investig Med. 2011;59(2):246–58.CrossRefGoogle Scholar
  43. 43.
    Szeto CC, Kwan BC, Lai FM, Tam LS, Li EK, Chow KM, et al. Tacrolimus for the treatment of systemic lupus erythematosus with pure class V nephritis. Rheumatology (Oxford). 2008;47(11):1678–81.CrossRefGoogle Scholar
  44. 44.
    Boneparth A, Radhakrishna SM, Greenbaum LA, Yen E, Okamura DM, Cooper JC, et al. Approach to membranous lupus nephritis: a survey of pediatric nephrologists and pediatric rheumatologists. J Rheumatol. 2017;44(11):1619–23.CrossRefGoogle Scholar
  45. 45.
    Groot N, de Graeff N, Avcin T, Bader-Meunier B, Brogan P, Dolezalova P, et al. European evidence-based recommendations for diagnosis and treatment of childhood-onset systemic lupus erythematosus: the SHARE initiative. Ann Rheum Dis. 2017;76(11):1788–96.CrossRefGoogle Scholar
  46. 46.
    Beck LH Jr, Salant DJ. Treatment of membranous lupus nephritis: where are we now? J Am Soc Nephrol. 2009;20(4):690–1.CrossRefGoogle Scholar
  47. 47.
    Bao H, Liu ZH, Xie HL, Hu WX, Zhang HT, Li LS. Successful treatment of class V+IV lupus nephritis with multitarget therapy. J Am Soc Nephrol. 2008;19(10):2001–10.CrossRefGoogle Scholar
  48. 48.
    Tselios K, Koumaras C, Gladman DD, Urowitz MB. Dyslipidemia in systemic lupus erythematosus: just another comorbidity? Semin Arthritis Rheum. 2016;45(5):604–10.CrossRefGoogle Scholar
  49. 49.
    Sinicato NA, da Silva Cardoso PA, Appenzeller S. Risk factors in cardiovascular disease in systemic lupus erythematosus. Curr Cardiol Rev. 2013;9(1):15–9.PubMedPubMedCentralGoogle Scholar
  50. 50.
    Ruiz-Irastorza G, Cuadrado MJ, Ruiz-Arruza I, Brey R, Crowther M, Derksen R, et al. Evidence-based recommendations for the prevention and long-term management of thrombosis in antiphospholipid antibody-positive patients: report of a task force at the 13th International Congress on antiphospholipid antibodies. Lupus. 2011;20(2):206–18.CrossRefGoogle Scholar
  51. 51.
    Hofstra JM, Wetzels JFM. Should aspirin be used for primary prevention of thrombotic events in patients with membranous nephropathy? Kidney Int. 2016;89(5):981–3.CrossRefGoogle Scholar
  52. 52.
    Compeyrot-Lacassagne S, Tyrrell PN, Atenafu E, Doria AS, Stephens D, Gilday D, et al. Prevalence and etiology of low bone mineral density in juvenile systemic lupus erythematosus. Arthritis Rheum. 2007;56(6):1966–73.CrossRefGoogle Scholar
  53. 53.
    Thakral A, Klein-Gitelman MS. An update on treatment and management of pediatric systemic Lupus erythematosus. Rheumatol Ther. 2016;3(2):209–19.CrossRefGoogle Scholar
  54. 54.
    Hickman RA, Gordon C. Causes and management of infertility in systemic lupus erythematosus. Rheumatology (Oxford). 2011;50(9):1551–8.CrossRefGoogle Scholar
  55. 55.
    Slater CA, Liang MH, McCune JW, Christman GM, Laufer MR. Preserving ovarian function in patients receiving cyclophosphamide. Lupus. 1999;8(1):3–10.CrossRefGoogle Scholar
  56. 56.
    Coscia LA, Armenti DP, King RW, Sifontis NM, Constantinescu S, Moritz MJ. Update on the teratogenicity of maternal mycophenolate mofetil. J Pediatr Genet. 2015;4(2):42–55.CrossRefGoogle Scholar
  57. 57.
    Tunnicliffe DJ, Singh-Grewal D, Chaitow J, Mackie F, Manolios N, Lin MW, et al. Lupus means sacrifices: perspectives of adolescents and young adults with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2016;68(6):828–37.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of PediatricsDell Medical School, University of Texas at Austin, Dell Children’s Medical Center of Central Texas, Pediatric NephrologyAustinUSA
  2. 2.Department of Pathology and Laboratory MedicineUC Davis School of MedicineSacramentoUSA

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