Katalinić Lea, Eliasson Emma, Bubić-Filipi Ljubica, Kes Petar, Anić Branimir, Basić-Jukić Nikolina
Lijec Vjesn. 2014 Jul-Aug;136(7-8):219-23.
Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus (SLE), associated with high morbidity and mortality. Up to 60% of SLE patients develop LN, and despite novel and potent therapeutic regimens, 5 to 22% develop end-stage renal disease within 15 years of diagnosis. While LN primarily affects younger individuals, it is important to choose optimal method of renal replacement therapy for those who develop end-stage renal disease. Numerous studies were carried out trying to solve problems of treatment of patients with LN. Increased risk of infections, disease recurrence in renal allograft, undefined criteria for follow-up of disease activity after transplantation, as well as higher inci- dence of rejection episodes and thrombotic events are well known risks which have postponed and restricted access to transplantation for patients with LN for long-time. However, numerous studies have demonstrated similar long-term survival in patients treated with haemodialysis or peritoneal dialysis, with clear superiority of renal transplantation regarding the prolonged survival and better quality of life for SLE patients. Many questions are still waiting for answers. Close cooperation between nephrologists and immunologists provides the best treatment for SLE patients with end-stage renal disease.
狼疮性肾炎（LN）是系统性红斑狼疮（SLE）的一种严重并发症，与高发病率和死亡率相关。高达60%的SLE患者会发展为LN，尽管有新颖且有效的治疗方案，但仍有5%至22%的患者在诊断后15年内发展为终末期肾病。虽然LN主要影响年轻人，但为那些发展为终末期肾病的患者选择最佳的肾脏替代治疗方法很重要。人们进行了大量研究以试图解决LN患者的治疗问题。感染风险增加、肾移植中疾病复发、移植后疾病活动随访标准不明确，以及排斥反应和血栓事件的发生率较高，这些都是众所周知的风险，长期以来推迟并限制了LN患者接受移植的机会。然而，大量研究表明，接受血液透析或腹膜透析治疗的患者长期生存率相似，而肾移植对于SLE患者的长期生存延长和生活质量改善具有明显优势。许多问题仍有待解答。肾病学家和免疫学家之间的密切合作可为终末期肾病的SLE患者提供最佳治疗。
