NIH conference. Lupus nephritis.

Nephritis has long been considered one of the most ominous components of systemic lupus erythematosus. Accumulations of immune complexes and lymphoid cells in several locations within the kidney are the best-described elements of lupus nephritis. The extreme diversity of the renal changes indicates that many variables are likely to be involved. Inbred strains of lupus-prone mice have provided homogeneous subjects for study of pathogenesis and response to treatment. Comparable grouping of lupus nephritis in humans according to unique or dominant pathogenetic mechanisms is imprecise and limited by insufficient knowledge of the primary stimulus for the disease. Treatment is also imperfect and, at times, hazardous. Certain regimens incorporating cytotoxic drugs provide a significant therapeutic advantage over corticosteroids alone in the management of this disease.