What Are The Six Classes of Lupus Nephritis?

Reviewed on 5/7/2021

Systemic lupus erythematosus (SLE) is an autoimmune disease that causes inflammation and pain in the skin, joints, kidneys, and brain. When SLE affects the kidneys, it's called lupus nephritis. There are six classes of lupus nephritis, which is based on the results of a kidney biopsy.
Systemic lupus erythematosus (SLE) is an autoimmune disease that causes inflammation and pain in the skin, joints, kidneys, and brain. When SLE affects the kidneys, it's called lupus nephritis. There are six classes of lupus nephritis, which is based on the results of a kidney biopsy.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that causes the body’s immune system to mistakenly attack its own organs and tissues, causing inflammation and pain, commonly in the skin, joints, kidneys, and brain, and may be fatal. SLE that affects the kidneys is called lupus nephritis. 

There are six classes of lupus nephritis, based on the results of a kidney biopsy. Seventy percent of people diagnosed with lupus nephritis are diagnosed as having Class 3, 4 or 5. Originally there were five different stages, but the International Society of Nephrology and the Renal Pathology Society established new classification into six classes, as follows:

  • Class 1: Minimal mesangial glomerulonephritis
    • Minimal kidney involvement
    • No obvious symptoms
  • Class 2: Mesangial proliferative glomerulonephritis
    • Some evidence of limited kidney inflammation 
    • Microscopic amounts of blood in urine and/or excess protein in urine 
  • Class 3: Focal glomerulonephritis
    • Involvement of less than half of the network of small blood vessels in the kidneys
    • Blood and/or excess protein in urine
    • Possible high blood pressure
  • Class 4: Diffuse proliferative nephritis
    • Involvement of more than half of the network of small blood vessels in the kidneys
    • Blood and/or excess protein in urine
    • Possible high blood pressure
  • Class 5: Membranous glomerulonephritis
    • Characterized by immune deposits found around the network of small blood vessels
    • Different from other forms of lupus nephritis
    • Blood and/or excess protein in urine
    • Possible high blood pressure
  • Class 6: Advanced sclerotic

What Are Symptoms of Lupus Nephritis?

Symptoms of lupus nephritis may include:

What Causes Lupus Nephritis?

The cause of lupus nephritis is unknown. 

Factors that may play a role in developing the disease include: 

  • Family history 
  • Environment 
    • Infections
    • Viruses
    • Toxic chemicals or pollutants (car fumes, factory smoke) 

How Is Lupus Nephritis Diagnosed?

In addition to a patient history and physical examination, tests used to diagnose lupus nephritis include:

  • Urine test to check for protein and blood
  • Blood tests
    • Protein levels
    • Cholesterol
    • Glomerular filtration rate (GFR) which shows how well the kidneys filter waste
    • Antiphospholipid antibodies  
    • Antinuclear antibodies (ANA) 
  • Kidney biopsy 

 

What Is the Treatment for Lupus Nephritis?

Lupus nephritis is treated with different types of medications, including:

  • Corticosteroids 
  • Immunosuppressive drugs
  • Blood pressure medications
    • Angiotensin converting enzyme (ACE) inhibitors 
    • Angiotensin receptor blockers (ARBs)
    • Diuretics
    • Beta-blockers
    • Calcium channel blockers
    • Other blood pressure medications
  • Antimalarials
  • Some chemotherapy drugs
  • Diet changes
    • Reducing Salt (Sodium) 
    • Reducing Protein 

QUESTION

Lupus is an infection. See Answer

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Reviewed on 5/7/2021
References
https://www.kidney.org/atoz/content/lupus

https://www.allinforlupusnephritis.com/about-lupus-nephritis/signs-and-symptoms