Keywords
LES
Clinical manifestations
Renal damage
How to Cite
Abstract
Introduction: Two of the most frequent Lupus nephritis (LN) diseases are multiple glomerulonephritis and renal fibrosis. Recent studies have verified that 10-30% of patients with SLE after several years (3-6 years) develop LN and end-stage chronic renal disease (ESRD) when there is a need for chronic intermittent hemodialysis (HD) treatment. [1, 2, 3]
The paper aimed to assess renal damage due to LN using the results obtained from the examined parameters in patients with chronic kidney disease (CKD) in the third stage (a and b).
Materials and Methods: This prospective cohort research (cross-section ") study included 100 patients with CKD (55 were men with an average age of 57.00±8.50 years old with chronic renal disease, 20 with diabetes mellitus (DM) and nephropathy diabetics, 15 were arterial hypertension (AHT), 11 were with chronic glomerulonephritis (CGN), 3 with Adult polycystic kidney disease (APCKD) and six patients were with undefined renal disease, while 45 were female with an average age of 55.80 ±10.50 years old), with primary kidney disease: 16-with diabetes mellitus and diabetic nephropathy,11 with HTA…
Statistical analysis of the examined material: The obtained results from the studied patients with CKD and the control group were statistically processed with arithmetic mean value, standard deviation X ± SD, with student, "t" test, Mann-Whitney and Wilcoxon test. The results were processed with the appropriate state-of-the-art statistical program, SPSS V26.
Results: the results obtained at the beginning of the study (for all patients with LN and CKD: women and men) and after 12 months of treatment are presented in tables and graphs 4 and 8.
Conclusion: From the results obtained, we can conclude that LES affects the appearance of renal damage; therefore, early detection and treatment of the initial stages of LN seem to influence the reduction of its activity.
References
2. Ortega LM, Schultz DR, Lenz O, Pardo V, Contreras GN. Review: Lupus nephritis: pathologic features, epidemiology and a guide to therapeutic decisions. Lupus. 2010 Apr;19(5):557-74. doi: 10.1177/0961203309358187. Epub 2010 Jan 20. PMID: 20089610.
3. Lupus nephritis: Symptoms, treatment, and complications. American Kidney Fund May 31, 2023. Manifestations of lupus in the kidney and how to manage them. Nephrology Dialysis Transplantation, Volume 32, Issue 10, October 2017, Pages 1614–1616,
4. Weening JJ, D'Agati VD, Schwartz MM, et al. International Society of Nephrology Working Group on the Classification of Lupus Nephritis; Renal Pathology Society Working Group on the Classification of Lupus Nephritis. The classification of glomerulonephritis in systemic lupus erythematosus revisited. Kidney Int. 2004 Feb;65(2):521-30. doi: 10.1111/j.1523-1755.2004.00443.x. Erratum in: Kidney Int. 2004 Mar;65(3):1132. PMID: 14717922.
5. Weening J.J, D'Agati V.D., Schwartz M.M., et al. Classification of glomerulonephritis in systemic lupus erythematosus revisited. J Am Soc Nephrol, 15 (2004), pp. 241-250.
6. Churg, J. and Sobin, L. (1982) renal disease: Classification and Atlas of Glomerular Disease. Igaku-Shoin, Tokyo.
7. J. Churg, J. Bernstein, R.J. Glassock. renal disease: Classification and Atlas of Glomerular Disease (2nd ed), Igaku-Shoin, New York (1995)
8. Furness P.N., Taub N. Interobserver reproducibility and application of the ISN/RPS classification of lupus nephritis – A UK-wide study. Am J Surg Pathol. 2006; 30: 1030-1035.
9. Zickert A, Sundelin B, Svenungsson E, Gunnarsson I. Role of early repeated renal biopsies in lupus nephritis. Lupus Sci Med. 2014;1(1):e000018.
10. Ortega LM, Schultz DR, Lenz O, Pardo V, Contreras GN. Review: Lupus nephritis: pathologic features, epidemiology and a guide to therapeutic decisions. Lupus. 2010;19(5):557–74.
11. Boodhoo KD, Liu S, Zuo X. Impact of sex disparities on the clinical manifestations in patients with systemic lupus erythematosus (https://pubmed.ncbi.nlm.nih.gov/27442661/).Medicine. 2016 July;95(29): e4272.
12. Lupus Foundation of America. What is lupus nephritis (https://www. lupus.org/reso-urces/what-is-lupus-nephritis)? Accessed 9/22/2021.
13. Lupus Foundation of America. What is lupus(https://www.lupus.org/resources/what-is-lupus)? Accessed 9/22/2021.
14. National Kidney Foundation. Lupus and Kidney Disease (Lupus Nephritis) (https:// www.kidney.org/atoz/content/lupus). We accessed 9/22/2021.
15. Austin HA. Clinical evaluation and monitoring of lupus kidney disease. Lupus 1998; 7:618-21.
16. Anne Davidson: What is damaging the kidney in lupus nephritis? Nat Rev Rheumatol. 2016 Mar; 12(3): 143–153.
17. Madaio MP. The role of autoantibodies in the pathogenesis of lupus nephritis. Semin Nephrol. 1999;19(1):48–56.
18. Hedberg A, Mortensen ES, Rekvig OP. Chromatin as a target antigen in human and murine lupus nephritis. Arthritis Res Ther. 2011;13(2):214.
19. Trouw LA, Groeneveld TW, Seelen MA, Duijs JM, Bajema IM, Prins complexes. J FA, et al. Anti-C1q autoantibodies deposit in glomeruli but are only pathogenic in combination with glomerular C1q-containing immune Clin Invest. 2004;114(5):679–88.
20. Ullal AJ, Reich CF, 3rd, Clowse M, Criscione-Schreiber LG, Tochacek M, Monestier M, et al. Microparticles as antigenic targets of antibodies to DNA and nucleosomes in systemic lupus erythe-matosus. J Autoimmun. 2011;36(3–4):173–80.
21. Hakkim A, Furnrohr BG, Amann K, Laube B, Abed UA, Brinkmann V, et al. Impairment of neutrophil extracellular trap degradation is associated with lupus nephritis. Proc Natl Acad Sci U S A. 2010;107(21):9813–8.
22. Seredkina N, Rekvig OP. Acquired loss of renal nuclease activity is restricted to DNaseI and is an organ-selective feature in murine lupus nephritis. Am J Pathol. 2011;179(3):1120–8.
23. Floege J, Eitner F, Alpers CE. A new look at platelet-derived growth factor in renal disease. Am Soc Nephr.2008;19(1):12–23.).
24. Daehn I, Casalena G, et al. Endothelial mitochondrial oxidative stress determines podocyte depletion in segmental glomerulosclerosis. J Clin Invest.2014;124(4):1608–21.
25. Kriz W, LeHir M. Pathways to nephron loss starting from glomerular diseases-insights from animal models. Kidney Int. 2005;67(2):404–19.
26. Bergtold A, Gavhane A, D’Agati V, et al. FcR-bearing myeloid cells are responsible for triggering murine lupus nephritis. J Immunol. 2006;177(10):7287–95.
27. Perez de Lema G, Maier H, Nieto E, et al. Chemokine expression precedes inflame-memory cell infiltration and chemokine receptor and cytokine expression during the initiation of murine lupus nephritis. J Am Soc Nephrol. 2001;12(7):1369–82.
28. Segerer S, Schlondorff D. Role of chemokines for the localization of leukocyte subsets in the kidney. Semin Nephrol. 2007; 27(3):260–74.
29. Vandepapeliere J, Aydin S, Cosyns JP, et al. Prognosis of proliferative lupus nephritis subsets in the Louvain Lupus Nephritis Inception Cohort. Lupus. 2014;23(2):159–65.
30. Dall’Era M, Cisternas M, Smilek D, et al. Predictors of long-term renal outcome in Lupus Nephritis Trials: Lessons learned from the Euro-Lupus Nephri. Cohort. Arthritis Rheum. 2015 May;67(5):1305-13.
31. Yung S, Chan TM. Anti-DNA antibodies in the pathogenesis of lupus nephritis--the emerging mechanisms. Autoimmun Rev. 2008 Feb. 7(4):317-21.
32. Davidson A, Berthier C, Kretzler M. Pathogenetic mechanisms in lupus nephritis. Wallace DJ, Hahn BH, eds. Dubois' Lupus Erythematosus and Related Syndromes. 8th ed. Philadelphia, PA: Elsevier Saunders; 2013. 237-55.
33. Grande JP. Mechanisms of progression of renal damage in lupus nephritis: pathogenesis of renal scarring. Lupus. 1998. 7(9):604-10. .
34. Lisnevskaia L, Murphy G, Isenberg D. Systemic lupus erythematosus. Lancet. 2014 Nov 22. 384 (9957):1878-1888.
35. Azzouz D, Omarbekova A, Heguy A, et al. Lupus nephritis is linked to disease-activity-associated expansions and immunity to a gut commensal. Ann Rheum Dis. 2019 Feb 19.
36. Berthier CC, Bethunaickan R. Cross-species transcriptional network analysis defines shared inflammatory responses in murine and human lupus nephritis. J Immunol. 2012;189(2):988–1001.
37. Lawrence H Brent, MD; Chief Editor: Vecihi Batuman, MD, Lupus Nephritis. 27, 2023.Medscape
38. Dooley MA. Clinical and epidemiologic features of lupus nephritis. Wallace DJ, Hahn BH, eds. Dubois' Lupus Erythematosus and Related Syndromes. 8th ed. Philadelphia, PA: Elsevier Saunders; 2013. 438-54.
39. 39.Pons-Estel GJ, Alarcón GS, et al. Protective effect of hydroxychloroquine on renal damage in patients with lupus nephritis: LXV, data from a multiethnic US cohort. Arthritis Rheum. 2009 Jun 15. 61 (6):830-9.
40. Houssiau FA, Ginzler EM. Current treatment of lupus nephritis. Lupus. 2008. 17(5):426-30.
41. Liu Z, Davidson A. (2011). BAFF and selection of autoreactive B cells. Trends in Immunology.;32(8):388–394.
42. Shlomchik MJ, Craft JE, Mamula MJ. (2001). From T to B and back: positive feedback in systemic autoimmune disease. Nature Reviews Immunology ;1(2): 147–153
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