REVIEW: Lupus nephritis: An approach to diagnosis and treatment in South Africa

  • IG Okpechi
  • A Gcelu
  • OI Ameh


Lupus nephritis (LN) is a significant cause of morbidity and mortality in patients with systemic lupus  erythematosus. Delayed recognition and diagnosis of LN may be a common cause of chronic kidney disease among South Africans. Renal biopsy is the gold standard of diagnosing LN; however, this service is not  available in many centres and the use of urinalysis, urine microscopic examination and other serological tests can be useful in identifying patients with proliferative LN. Proliferative types of LN (class III, class IV and  mixed class V) comprise the larger proportion of patients with this condition. Patients receiving  immunosuppressive therapy need to be monitored closely for side-effects and drug-related toxicities. LN patients with end-stage renal disease (class VI) need to be prepared for renal replacement therapy (dialysis  and renal transplantation). In all patients, treatment should include adjunctive therapies such as renin  angiotensin aldosterone system blockade, bone protection (with calcium supplements and vitamin D), blood  pressure control and chloroquine – all of which help to retard the progression of kidney disease.

Journal Identifiers

eISSN: 2078-5135
print ISSN: 0256-9574