Lupus nephritis is inflammation of the kidney that is caused by systemic lupus erythematous (SLE). Also called lupus, SLE is an autoimmune disease. With lupus, the body's immune system targets its own body tissues. Lupus nephritis happens when lupus involves the kidneys. In addition to an ACE inhibitor or an ARB, a diuretic—a medication that helps the kidneys remove fluid from the body—may be prescribed. Beta blockers, calcium channel blockers, and other blood pressure medications may also be needed.
In the 1950s, the estimated 5-year survival was less than 50% , but recent studies report 5-year survival of over 90% . Nevertheless, the mortality rate in SLE still exceeds that of the general population. Death related to lupus activity and infection has decreased over time, but still contributes to mortality , especially in developing countries. However, CVM has not declined in SLE. A slight increased standardized mortality ratio (SMR) due to vascular diseases has been reported .
People with lupus nephritis that is causing high blood pressure may need to take medications that lower their blood pressure and can also significantly slow the progression of kidney disease. Two types of blood pressure lowering medications, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. Many people require two or more medications to control their blood pressure.
Abatacept and Cyclophosphamide Combination Therapy for Lupus Nephritis, funded under NIH clinical trial number NCT00774852, compares the addition of the experimental medication abatacept to standard cyclophosphamide therapy with cyclophosphamide therapy alone for treatment of lupus nephritis. Immune System Related Kidney Disease, funded under NIH clinical trial number NCT00001979, studies patients with autoimmune diseases of the kidney, including lupus nephritis.