Melderis S, Wiech T, Iking-Konert C, Steinmetz O M
Zentrum für Innere Medizin, III. Medizinische Klinik und Poliklinik (Nephrologie/Rheumatologie mit Sektion Endokrinologie), Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, Gebäude Ost 10, 20246, Hamburg, Deutschland.
Zentrum für Diagnostik, Institut für Pathologie (Sektion Nephropathologie), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Z Rheumatol. 2018 Sep;77(7):593-608. doi: 10.1007/s00393-018-0496-4.
Lupus nephritis (LN) is a common major organ manifestation of systemic lupus erythematosus (SLE) and causes significantly increased morbidity and mortality. Thus, all patients with SLE should be regularly screened for LN. While new onset glomerular hematuria or proteinuria are suggestive for LN, a kidney biopsy is the gold standard for diagnosis and classification. The treatment of LN comprises strict blood pressure control and administration of hydroxychloroquine. Aggressive forms of LN require additional treatment with immunosuppressive induction therapy followed by a maintenance phase for several years. Given the high rate of disease recurrence, life-long follow-up control in specialized centers is necessary. Despite optimal care a significant proportion of patients still develop chronic kidney failure. Better disease activity markers as well as more potent and specific therapeutic agents are thus urgently needed.
狼疮性肾炎(LN)是系统性红斑狼疮(SLE)常见的主要器官表现,会显著增加发病率和死亡率。因此,所有SLE患者都应定期筛查LN。虽然新发肾小球血尿或蛋白尿提示LN,但肾活检是诊断和分类的金标准。LN的治疗包括严格控制血压和给予羟氯喹。侵袭性LN需要额外进行免疫抑制诱导治疗,随后进入数年的维持期。鉴于疾病复发率高,在专科中心进行终身随访控制是必要的。尽管给予了最佳治疗,仍有相当一部分患者会发展为慢性肾衰竭。因此,迫切需要更好的疾病活动标志物以及更有效、更具特异性的治疗药物。