What Factors Will Worsen Lupus Nephritis

The prognosis of Lupus Nephritis may vary from case to case because many factors can affect the progression of the disease. Generally speaking, the following factors will worsen Lupus Nephritis.

⑴ Infection

Preventing infections such as colds play a very important role in improving the patients’ survival.

In Lupus Nephritis, the renal functional cells are damaged severely. If there is infection in body, the impaired cells will attract the inflammatory factors thus causing more damage to them.

⑵ Lupus activity

If lupus is not controlled effectively, it will bring more damage to kidneys and other organs and tissues. The following factors may trigger the lupus activity:

Exposure to sunlight for a long time

Infections

Foods that can cause allergic response

Pregnancy

⑶ Frequent relapses

Every relapse is a big trauma to kidneys and will cause violent inflammatory response in glomeruli. If the disease relapses quite frequently, it will develop into Renal Failure in a short time.

However, hormone and immunosuppressive agents only can relieve the symptoms of Lupus Nephritis and suppress the inflammatory response temporarily. As it can not eliminate its root causes, the disease is at high risk of relapsing.

⑷ Complications of Lupus Nephritis

Proteinuria is a risky factor in aggravating renal function. Proteinuria has toxityand it can cause damage to mesangial cells and cause matrix svnthesis thus accelerating the glomerulosclerosis.

High blood pressure can damage the kidney capillaries and improve their permeability. In return, it can promote the protein leakage significantly.

The above article has introduced the factors which can worsen Lupus Nephritis. If the patients can avoid those factors, they will get a favorable prognosis.

Meanwhile, if the patients can receive effective treatment, they will be able to stop the disease progression. In our hospital, the latest therapy—immunotherapy is applied to treat Lupus Nephritis and has showed a remarkable curative effect.

It aims at regulating the autoimmune process to stop the attack to glomeruli.

It controls the symptoms by restoring the impaired glomeruli.

It is a combination therapy of natural therapy and biotherapy so it does not have side effects on body.

Lupus Nephritis: Tell Me Proper Suggestions for Kidney Recovery

Lupus nephritis is a type of kidney disease caused by lupus that is an autoimmune disease. Lupus would be flare or remission, so it determines the development of lupus nephritis with a great extent. Are there some proper suggestions for kidney recovery?

In most cases, the flare of lupus would not only hurt skin or joints but also will further damage the kidneys meanwhile. When lupus is flare, their immune system is disordered and the anti-body or immune cells cannot tell the difference between foreign invaders or domestic cells. So kidney tissues are damaged and a large number of immune complexes are formed at the same time. These immune complexes also would lead to renal inflammation, so patients will first get blood purification to remove all the immune complexes out of the body. After this, many symptoms of patients will be greatly remitted. Especially the skin damage and dental ulcer would be recovered after several times of blood purification. This is one of steps of immunotherapy that is the individualized treatment in our hospital.

Someone may say it is a temporary treatment for lupus nephritis, can you provide an effective therapy to treat it from the root?

Then another step of Immunotherapy--immune regulation will benefit patients. In this treatment, we provide Micro-Chinese Medicine Osmotherapy. It is known that Chinese herbs can balance immune system with a wonderful effect. We have one of few teams committed to Chinese medicine and they can give you suitable prescription in order to adjust immune system and all the organs and tissues. Once your immunity is improved, the frequency of lupus flare will be greatly reduced. Besides, these immune complexes can be resolved by Chinese herbs ingredients. As a result, it can block the renal inflammation from the root.


Furthermore, micro-Chinese medicine Osmotherapy is an external application that means no hurt and no side effect for patients. Patients need to lie on the little medicine bags and the devices will help the ingredients go into the body to function. If you like this therapy, you can have a try and online experts will tell you the details.

Patient with lupus nephritis, chronic renal failure Stage 5 CKD, renal anemia

1. Medium patient

Name: Dilshad

Sex: female

Age: 48a?os

Nationality: India

2. Diagnosis: Lupus nephritis, chronic renal failure Stage 5 CKD, renal anemia

3. Introduction of disease: Patient a year ago due to fever rash miliary type of body, nausea, vomiting, fatigue, treatment in a local hospital, measurement of renal function occur: serum creatinine 11mg / dl, hemoglobin 72g / l , urine protein .Anticuerpos + + antinuclear, anti DNA antibodies double + chain, the diagnosis is "lupus nephritis, chronic renal failure stage 5 CKD, renal anemia, dialysis, step down, iron supplements, supplements blood and other treatments, patient for further treatment on 3/5/2012 first came to our hospital.

4. After you came to our hospital, did test: hemoglobin: 72g / l, serum creatinine: 538umol / l, uremic Nitrogen 25.7mmol / l after oral poison auxiliary exhaust and treatment of Micro-Chinese Medicine, hemoglobin maintained at 90g / l, creatinine controlled 300-350umol / l, antinuclear antibodies, antibody-dsDNA - now did dialysis patient.

Pharmacological treatment of lupus nephritis

Treatment included remission induction and maintenance therapy.

1. Aspires Remission induction is fast disease control, disease strive complete remission (including functional recovery of serological markers, symptoms and organ damage).

2. Maintenance therapy with low dose immunosuppressive agents to control the disease, prevention of disease recurrence and small drug side effects.

(1) Glucocorticoids: It's main drug treatment can significantly improve clinical and prognosis of patients, but the specific product should be based on whether there SLE disease activity and treatment type and follow the principle of individual classification.

① Prednisone: Adults are 0.8 ~ l mg / (kg / d), a total of 8 ~ 12 weeks after stable condition, enters phase reduction treatment to the maintenance dose (every other day 0.4mg / kg), full course of treatment of 1-2 years or more.

② The methylprednisolone pulse therapy: activities for SLE and LN pathological changes in severe cases, such type Ⅳ ln fusion crescent formation. Common scenarios: Each 1 g of methylprednisolone intravenously daily or every two days, a time, three times during a course, if necessary, within 3 to 7 days repeat, Total 1 ~ 3 courses. But pay attention to complications such as infections and sodium retention.

(2) Cytotoxic drugs: For the type of diffuse proliferative LN or poor patients hormone efficacy must be added cytotoxic drugs.

① Cyclophosphamide (cyclophosphamide, CTX): General methods oral CTX is 2 ~ 4 mg / (kg / d), but now considered NIH program is superior to conventional methods orally, used CTX 0.5 ~ 1.0g / m2 surface area body, enters 0.9% saline intravenous infusion of 250 ml, less than 1 hour, 1 time each month crash, a total of 6 times, then every three months shock 1 time still active after leaving impact 1 year, Total <12g. Treatment should pay attention to the fully hydrated alkaline urine, and to monitor changes in the blood, adverse reactions are reversible myelosuppression, infection, have nausea, vomiting, alopecia, gonadal suppression, hemorrhagic cystitis, carcinogenic, teratogenic ect. European programs: CTX 500 mg iv / 2 weeks, a total of 6 times, then give azathioprine 2 mg / kg, Total 2.5 years. NIH and European programs combined with hormone therapy.

② The azathioprine (azathioprine): Dose l ~ 2mg / (kg / d), dose glucocorticoid therapy usually combined, or as maintenance therapy.

③ mycophenolate mofetil (MMF): As a new immunosuppressant, can selectively inhibit the proliferation of T and B lymphocytes suitable for the treatment of refractory ln, produce slow efficacy, along with hormone over, starting dose is 1.5 ~ 2.0g / d, achieved clinical remission after reduced to 1.0g / d, after the past six months, down to 0.75g / d, maintenance dose is usually not less than 0.5g / d, total treatment 1.5 ~ 2 years. Gastrointestinal side effects were reactions, infections, bone marrow suppression.

④ glycosides Tripterygium: 60 mg / day, divided doses, combined with hormones have some effect on LN, for mild or hormone, upon removal of reducing immunosuppression is most suitable for maintenance treatment, major adverse reactions were myelosuppression, gonadal suppression, liver toxicity, menstrual disorders and gastrointestinal symptoms.

⑤ Cyclosporine (cyclosporine): Using starts 3 ~ 5mg / (kg / d), after taking 2-3 months Monthly least lmg / kg, reduced to 2.5mg / kg maintenance therapy doing. The main adverse reactions is liver toxicity, gastrointestinal symptoms, gingival hyperplasia and hirsutism.

⑥ Tacrolimus (tacrolimus) inhibit the activity of T cells and inflammatory cytokine responses, some scholars have suggested for the treatment of V-LN. Initial amount 0.08 ~ 0.1mg / (kg · d), two oral, with a low trough concentration is 5 ~ 15ng / ml. Should be based on the plasma concentration and dose adjustment Scr, after remission can be reduced 0.05mg / (kg / d), continued six months. Side effects include muscle tremors, hyperglycemia, A transient increase in creatinine, hepatic failure.

⑦ Leflunomide (1eflunomide): Leflunomide activity is an anti - immunomodulators proliferative different azoles, its mechanism is inhibition of dihydroorotate dehydrogenase activity and affects the pyrimidine synthesis of activated lymphocytes. Use once a day, every 2. Initially, three days dose (50mg / day) load, after the maintenance dose of 20 mg / day. Side effect is diarrhea, rash, bone marrow suppression, gonadal suppression, liver toxicity, small number of patients with pulmonary fibrosis.

(3) The ways of treatment are studied:

① The x-ray irradiation Systemic lymph, 20 Gy course of 4 to 6 weeks.

② Dealing in vitro immunoadsorption, general 3 ~ 7 times.

③ therapy with anti-CD4 monoclonal antibodies as 0.3 mg / kg intravenously.

④ immune reconstitution therapy: The use of large doses of CTX with hematopoietic stem cells, eliminating the disease in bone marrow-derived immune cells.

Above is the pharmacological treatment of lupus nephritis? If you are interested in our items, still pay attention to us please! We articles on various diseases of kidneys, include rudimetos, symptoms, treatment, diet and Fitness has all the information? If you have any problem, you can consult our experts online or leave a message below!

Precipitating and pathological factors of lupus nephritis

Precipitating factors

① genetics and physics: Close relatives of patients the incidence of up to 5% and 12%, the incidence of monozygotic twins is 69%, the incidence of fraternal twins is only 3% blacks and Asians .The incidence significantly more, it is suggested that the disease depends on genetic factors. Genetic susceptibility disease gene is located on chromosome 6. significantly higher incidence in women, suggest the role of endocrine factors.

② Environmental Factors: As seen from genetic factors is just a trend Susceptible, environmental factors be this disease plays an important role. virus infection such lentiviral virus infection - C, factors drugs such as penicillin, hydralazine, procainamide, isoniazid, methyldopa, quinidine lvpumaqin and ect. There are possible that amine and hydrazine drugs and thiol groups a relationship. After drugs and binding of nuclear histones, and the role of lymphocyte autoimmunity form. Drug-induced systemic lupus erythematosus rarely violates the kidney and central nervous system. Irradiation of sunlight (UV) aggravate common disease in 40% of patients, UV DNA can converte the secret scam pyridine dimer, let this increased antigenicity, trigger the disease.

Pathophysiology

Glomerular lesions: common immune complexes can soothe, intrinsic cells (mesangial, endothelial and epithelial) swelling, hyperplasia, multicore and infiltration of mononuclear cells and capillary segmental necrosis. It is important to immune complex deposition in glomerular is basic lesion of the disease, may be deposited on the skin, endothelium, in the basal and mesangial membrane immunopathology IgG showed strong staining, often accompanied IgM and IgA, complement C3, Clq and C4 also more strongly positive, over 25% of patients showed a performance "full house" .Other changes, irregular pieces can mix things quiet subendothelial optical microscopy showed glomerular capillary drawing, also known as "white gold ear" phenomenon.

1. Macroalbuminuria: When molecules glomerular filtration membrane barriers and barrier determined by charge barrier is damaged glomerular filtration membrane plasma proteins (mainly albumin right) increased permeability to increase the protein content in urine original, when more amount of absorption back uptake distal tubule form massive proteinuria.

2. hematuria When the immune response to glomerular endothelial injury, damage of the filter membrane, the red blood cells form urine overflows hematuria.

3. Edema: hypertension, oliguria, hypoalbuminemia are the main reasons for edema LN.

Above is the precipitating factors and disease lupus nephritis? If you are interested in our items, still pay attention to us please! We articles on various diseases of kidneys, include rudimetos, symptoms, treatment, diet and the gym has all the information? If you have any problem, you can consult our experts online or leave a message below!

The differential diagnosis of lupus nephritis

Laboratory tests

① General inspection: The majority of patients (80%) had a moderate anemia (anemia pigmented cells are positive) rarely showed hemolytic anemia, thrombocytopenia, 1/4 patients with pancytopenia, 90% accelerate ESR. Globulin patients was significantly higher.

② Immunological tests:

(1) Antinuclear Antibody: Sensitivity of antinuclear antibodies in 90%, but lower specificity in mixed connective tissue disease, rheumatoid arthritis, Sjogren's syndrome etc can be positive. Therefore, this test is not the only indicator for diagnosis, can be used as indicators of disease activity reference, however, its titer and severity of renal disease or not has nothing to do.

(2) anti-dsDNA antibodies: an antibody that is diagnostic marker of SLE, the sensitivity of 72%, the change in titer and is closely related to the activity occasionally lupus.Sólo syndrome in sjogren, active rheumatoid arthritis and hepatitis are positive.

(3) antibodies and anti-anti-RNP Sm: Sm antibodies common in 25% -40% of patients illness, common anti-RNP antibodies in 26% -45% of patients. Anti-Sm antibody specificity in the diagnosis of systemic lupus erythematosus high.

(4) anti - histones: Common in 25% -60% of patients. Specificity are better, although common in rheumatoid arthritis and Sjogren's syndrome etc.

(5) antibodies and anti-anti -SSB SSA: The first is common in 30% -40% of patients, the latter is only 0-15% .Both antibodies were mainly observed in Sjogren's syndrome.

(6) Other antibodies: SLE and a variety of other autoantibodies, such as hemolytic anemia, anti-erythrocyte antibodies, necrotizing vasculitis and neutrophil cytoplasmic antibodies (ANCA) etc. in recent years special attention antiphospholipid antibodies, common in 34% of patients .

(7) Complement: C3, C4, CH50 can reduce, in particular, C3 decreased activity of lupus is a sensitive and reliable determine indicators.

(8) Band lupus Skin: Epidermis of non-lesional skin and dermis town link, using direct immunofluorescence, may have IgG and (o) C3 granulated calm band yellow-green fluorescence. The disease is common in patients with more than 70%.

(9) Other: Rheumatoid factor (RF) and cold globulin test can be positive activists pathological changes.

Above is the differential diagnosis of lupus nephritis? If you are interested in our items, still pay attention to us please! We articles on various diseases of kidneys, include rudimetos, symptoms, treatment, diet and Fitness has all the information? If you have any problem, you can consult our experts online or leave a message below!

Clinical manifestations of lupus nephritis

Systemic manifestations

Systemic manifestations of lupus nephritis with fever, arthritis and skin damage the mucous membrane is the most common. With the participation of the system there are liver, heart, central nervous system and blood-forming organs, one third of patients have poliserositis (pleura and pericardium) ect. Pulmonary hemorrhage may also be a major manifestations of this disease, Goodpasture there with small vessel vasculitis and phase identification, Raynaud's phenomenon is common in 40% of patients.

Renal manifestations:

① Subclinical or type "silence": No behavior of renal disease, negative urine. But pathological examination often have different degrees of injuries.

② In light type: 30% to 50%, no clinical symptoms, just mild and moderate proteinuria (

③ The type of nephrotic syndrome: About 40% to 60%, showed massive proteinuria, hypoproteinemia and edema, occasional high cholesterol, blood pressure have late disease, renal dysfunction, most patients developed renal failure.

④ The type of chronic nephritis: About 35% to 50% have high blood pressure, varying degrees of proteinuria, urine has a large number of red blood cells and tube, more related to renal dysfunction.

⑤ The type of acute nephritis: The demonstrations are the clinical manifestations of acute nephritis.

⑥ Rapidly progressive glomerulonephritis type: oliguric acute renal failure appears on the short term. Or for mild converte nephrotic syndrome. Pathology revealed glomerulonephritis.

⑦ Type tubulointerstitial injury: Clinical manifestations is renal tubular acidosis, nocturia, hypertension, urinary β2 - microglobulin increased, half of the patients, the low renal dysfunction.

⑧ Type of antiphospholipid antibodies: The main clinical manifestations is the large and small arterial and venous thrombosis and embolism, and reduce platelet and abortion.

⑨ Type of acute renal failure: acute oliguric renal failure and appears in the short term, pathological manifestations is acute tubular necrosis.

⑩ Type of chronic renal failure: Different degrees of proteinuria, hematuria and edema, renal dysfunction there.

Above mentioned are the clinical manifestations of lupus nephritis? If you are interested in our items, still pay attention to us please! We articles on various diseases of kidneys, include rudimetos, symptoms, treatment, diet and Fitness has all the information? If you have any problem, you can consult our experts online or leave a message below!

The lupus nephritis disease care

1. Psychological care: Disease or take hormones can cause change posture and appearance, unable to bear children, and some loss of function in patients with severe, the depressed patient, overloaded thought lost confidence in life, rejects an treatment. The family members should talk to the patients, allowing patients to feel the warmth and love of people around social, to increase confidence in treatment, and explains reactions are reversible.

2. Diet Care: You have to eat out high-calorie, high in vitamins, low salt diet, in addition to kidney failure can give a high protein diet, use conditional long-term milk, especially colostrum, because the colostrum contains many antibodies, increased immunity.

3. Day care: Outdoor activities can be coated chloroquine face cream, wear long sleeves, wear a wide-brimmed hat, reduce sunlight, prevent skin damage is severe. Interior must there curtain. Good oral care, available in 4% sodium mouthwash to prevent fungal infections, have an oral fungal infection taking nystatin 500,000 units three times a day, or a solution of 1-4% clotrimazole rinsing 3 4 times daily. For finger, toes, nose, earlobes and other parts of the widespread melting arteritis Raynaud's phenomenon, should keep warm and avoid freezing necrosis distal limb.

4. Care medicines: Expert Treatment of lupus nephritis patients should be instructed to correct the use of corticosteroids. After control of the disease can be taken daily or every other day, 07 8:00 a.m.-taking medicine, in order to reduce the inhibitory effect of drugs on the adrenal cortex, and method of making the drug less, so as not to cause a phenomenon of "rebound".

5. To prevent colds and infections: Once the infection, antibiotics should be used much immediately. When patients with lupus nephritis home care, to prevent colds currently hot note. If after a cold, to follow doctor's orders, small renal toxicity taking medicines for colds, for example Victoria c silver fins, oral SHL, Isatis ect.

6. Be careful rehabilitation: Patients with lupus nephritis should have enough sleep, to reduce fatigue while it may be appropriate to participate in various activities, housework and abundance of recreational activities, farmers can be hand light work.

7. Patients with lupus nephritis episodes alternate referral if symptoms recur, it is necessary to consult a doctor.Dosage fatigue, infections, birth often relapse incentives should be taken to avoid. Women of childbearing age should contraception, multiple organ damage should terminate the pregnancy. For organ damage is not apparent, long illness yet, in families, no person urgent desire fertility, under the direction of physicians also have safe delivery, mother and safe preceding child, but should be done under strict medical supervision .

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Disease prevention of lupus nephritis

This article is regarding prevention of disease lupus nephritis? If you are interested, please read next paragraph!

Note genetic predisposition: The incidence of systemic lupus erythematosus close relatives about 5% to 12%, the incidence of monozygotic twins 69%, women are prone populations, which suggests that estrogen related to the pathogenesis of lupus nephritis. therefore, for patients with autoimmune diseases should be on high alert, once the disease should think yes or no have an autoimmune disease, Once the patient has to be actively tried to prevent the emergence of lupus nephritis.

The greater virus infection due to the virus infection concerns appearance of systemic lupus erythematosus. Therefore, we should actively treat a variety of viral infections. Especially for viral upper respiratory tract as "mild illness" should not be taken lightly. Attention to drug toxicity, drug-related lupus there hydralazine, procainamide, isoniazid, methyldopa, quinidine ect, both were common, especially. So for no genetic basis of lupus erythematosus patients, it should be noted that these drugs can induce lupus.

Avoid exposure to sunlight, UV irradiation aggravate lupus nephritis disease is more common. Due to ultraviolet rays can change the DNA thymine dimers, allowing increased antigenicity, promote systemic lupus erythematosus occurs. Therefore, patients with lupus nephritis in daily life should avoid prolonged exposure to sunlight, to reduce excessive ultraviolet radiation caused kidney damage.

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The pathogenesis of lupus nephritis

Lupus nephritis (LN) is systemic lupus erythematosus (SLE) involving the kidneys caused by an immune complex glomerulonephritis, is SLE major cause of death and major complications. Lupus Erythematosus (systemic lupus erythematosus, SLE) is a clinical manifestation of multiple system damage symptoms of chronic systemic autoimmune disease, having anti-nuclear antibody-based serum from a number of different autoantibodies. This disease in remission and acute episodes are characterized by alternating, no offal (kidneys, central nervous system) bad prognosis damage. The prevalence of this disease in our country 1/1000, higher than in Western countries report 1/2000, is more common in women, especially women of childbearing age 20-40 years old.

Pathogenesis

This disease is endogenous body (in person) antigens produce immune complex disease. B cells of SLE patients, the proliferation of highly active, producing a variety of autoantibodies, such as anti-nuclear antibody, anti -single- stranded, double-stranded DNA antibodies, the anti - histones, the anti - RNP antibody -SM anti ect. All of the above substance are anti - nuclear (antigen) antibody. Other anti - cytoplasmic antigen-antibody, for example anti - anti -plaquetas ect erythrocyte antibodies - ribosomal against blood cell surface antigens, anti drug - lymphocytes, antibodies. These antigens and antibodies to form immune complexes disease, deposited in various body tissues, eliciting an immune response, various tissue and organ damage. The SLE is a heterogeneous disease, different patients may variar.Calma immune abnormalities in glomerular immune complexes via the classical pathway of complement activation, the patients serum complement Clq, C3, C4 ingredients are significantly reduced, the strings solution prepared and levels of factor B in normal or slightly decreased. In addition, infiltration of white blood cells, platelets, and intrinsic renal cells in the inflammatory state, is capable of producing a variety of cytokine-mediated inflammatory more injuries.