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[Renal manifestations in connective tissue diseases]
Georg R Herrnstadt1, Marie-Therese Holzer2, Oliver M Steinmetz1
1III. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Zeitschrift Fur Rheumatologie
|November 8, 2022
Summary
Connective tissue diseases (CTD) can severely impact kidneys, often before symptoms appear. Early screening and kidney biopsy are crucial for diagnosing and treating renal involvement in CTDs like lupus nephritis.
Area of Science:
- Nephrology
- Rheumatology
- Internal Medicine
Context:
- Connective tissue diseases (CTDs) frequently impact kidneys, leading to irreversible damage.
- Early detection and diagnosis are vital as renal involvement often precedes systemic symptoms.
- Kidney biopsy remains the gold standard for diagnosing, prognosing, and guiding treatment.
Purpose:
- To provide an overview of the diverse renal manifestations in various CTDs.
- To highlight the importance of early screening and diagnosis for kidney involvement in CTDs.
- To differentiate key renal pathologies like lupus nephritis, tubulointerstitial nephritis, and antiphospholipid syndrome nephropathy.
Summary:
- Systemic lupus erythematosus (SLE) commonly causes lupus nephritis (LN), potentially leading to end-stage renal failure if untreated.
- Sjogren's syndrome involves tubulointerstitial nephritis, distinct from LN, with less studied prevalence and treatment guidelines.
- Systemic sclerosis (SSc) can present with a rare but fatal renal crisis, and antiphospholipid syndrome (APS) nephropathy involves thrombotic microangiopathies.
Impact:
- Emphasizes the critical role of vigilance and diagnostic tools in managing CTD-related kidney disease.
- Underscores the need for tailored treatment strategies based on specific renal pathology and clinical parameters.
- Highlights the recent approval of targeted therapies for LN, improving treatment options beyond traditional immunosuppressants.
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