Lupus nephritis – modern aspects of diagnosis and therapy. Part I

S. Solovyev, N. Kozlovskaya, E. Aseeva, A. A. Baranov, N. Nikishina, E. Nasonov
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Abstract

Lupus nephritis (LN) is considered to be one of the most frequent severe manifestations of systemic lupus erythematosus (SLE), its various colonic manifestations occur in at least 50% of SLE patients, both at the onset and at various stages of the disease, and develop LN is considered one of the most important predictors of mortality in SLE. The structure of nephritis is dominated by diffuse proliferative LN with clinical and morphological signs of progression and the rapid development of terminal renal failure. SLE is diagnosed based on the 2019 EULAR/ACR (European Alliance of Associations for Rheumatology/American College of Rheumatology) diagnostic classification criteria. To confirm the diagnosis, evaluate the prognosis, and choose the tactics of treating the dis-ease, all patients in the absence of contraindications require a kidney biopsy. In addition to LN, the spectrum of SLE-associated renal lesions includes vascular pathology represented by thrombotic microangiopathy, lupus vasculopathy or vasculitis, tubulointerstitial injury, and lupus podocytopathy.
狼疮性肾炎--现代诊断与治疗。第一部分
狼疮性肾炎(LN)被认为是系统性红斑狼疮(SLE)最常见的严重表现之一,至少有 50%的系统性红斑狼疮患者在发病初期和疾病的不同阶段会出现各种结肠表现,而出现 LN 被认为是系统性红斑狼疮患者死亡率的最重要预测因素之一。肾炎的结构以弥漫性增生性 LN 为主,并伴有临床和形态学上的进展迹象,迅速发展为终末期肾功能衰竭。系统性红斑狼疮的诊断依据是2019年EULAR/ACR(欧洲风湿病学协会联盟/美国风湿病学会)诊断分类标准。为了确诊、评估预后和选择治疗策略,所有无禁忌症的患者都需要进行肾活检。除LN外,系统性红斑狼疮相关肾脏病变还包括以血栓性微血管病变、狼疮血管病变或血管炎、肾小管间质损伤和狼疮荚膜细胞病变为代表的血管病变。
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