Diffuse proliferative lupus glomerulonephritis. Recovery from prolonged renal failure

Area of Science:

• Nephrology
• Rheumatology
• Immunology

Background:

• Systemic lupus erythematosus (SLE) is an autoimmune disease that can cause lupus nephritis, a severe kidney inflammation.
• Diffuse proliferative lupus glomerulonephritis represents a significant risk factor for progressive renal failure in SLE patients.
• Deteriorating renal function in lupus nephritis necessitates timely and effective therapeutic interventions.

Observation:

• A patient diagnosed with SLE and diffuse proliferative lupus glomerulonephritis presented with rapidly worsening kidney function.
• The patient underwent a treatment regimen combining immunosuppression and hemodialysis over an eight-week period.
• Close monitoring revealed a substantial recovery of renal function during the treatment phase.

Findings:

• Following the intervention, the patient experienced significant improvement in renal function, enabling the discontinuation of hemodialysis.
• Over the subsequent year, endogenous creatinine clearance increased to 30 mL/min, indicating partial but meaningful renal recovery.
• The case suggests a positive response to immunosuppressive therapy in severe lupus nephritis.

Implications:

• A therapeutic trial of prednisone should be considered for SLE patients with acute, severe renal function decline and evidence of active lupus nephritis.
• Early intervention with immunosuppression may halt or reverse the progression of renal damage in lupus nephritis.
• This case underscores the potential for recovery of renal function in severe cases of lupus nephritis with appropriate management.