[Prognosis and therapy of inflammatory rheumatic diseases : Impact of renal manifestations].

BACKGROUND

Inflammatory rheumatic diseases and their treatment cause various renal manifestations requiring modification of treatment.

OBJECTIVES

Discussion of renal manifestations in selected rheumatic diseases, including their impact on general prognosis and therapy.

MATERIALS AND METHODS

Basic literature and expert opinions are analyzed and discussed.

RESULTS

Inflammatory rheumatic diseases and their treatment cause various renal manifestations, including glomerular, tubular, interstitial, and vascular damage. The type of damage determines both, associated clinical symptoms (i.e. hematuria, proteinuria, loss of kidney function) and the renal and overall survival as will be discussed here for rheumatoid arthritis, systemic lupus erythematosus, scleroderma, Sjögrens syndrome, cryoglobulinemia and ANCA-associated vasculitis.

CONCLUSION

Renal manifestations are generally indicators of high disease activity and usually require more intensive treatment of the underlying rheumatic disease. Early and rigorous treatment, which has to be adapted to renal function, is capable of improving renal and overall survival in many of the affected patients.