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Highly Accessed Open Badges Editorial

Kidney disease in lupus is not always 'lupus nephritis'

Hans-Joachim Anders1* and Jan J Weening23

Author Affiliations

1 Renal Division, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstraße 1, 80336 Munich, Germany

2 Department of Pathology, Erasmus University Medical Center, Postbus 2040, 3000 Rotterdam, The Netherlands

3 Department of Pathology, Tergooiziekenhuizen, Postbus 10016, 1201 Hilversum, The Netherlands

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Arthritis Research & Therapy 2013, 15:108  doi:10.1186/ar4166

See related research by Song et al.,

Published: 1 March 2013


In lupus erythematosus, elevated serum creatinine levels and urinary abnormalities implicate a kidney disorder, which may not always be lupus nephritis as defined by the current classification of the International Society of Nephrology/Renal Pathology Society. The signs of renal dysfunction may be caused by lupusunrelated renal injury such as drug toxicity or infection or by lupus-associated mechanisms that are not part of the classification, such as minimal change nephrotic syndrome or thrombotic microangiopathy. The latter seems to complicate lupus nephritis more frequently than previously thought. An unbiased assessment of kidney disease in lupus requires a kidney (re-)biopsy to define the appropriate management.