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Diagnosis

  Diagnosis

  Laboratory tests to evaluate renal function in SLE patients include the following:

  Blood urea nitrogen (BUN) testing

  Serum creatinine assessment

  Urinalysis (to check for protein, red blood cells [RBCs], and cellular casts)

  Spot urine test for creatinine and protein concentration

  24-hour urine test for creatinine clearance and protein excretion

  Laboratory tests for SLE disease activity include the following:

  Antibodies to double-stranded DNA (dsDNA)

  Complement (C3, C4, and CH50)

  Erythrocyte sedimentation rate (ESR)

  C-reactive protein (CRP)

  Renal biopsy should be considered in any patient with SLE who has clinical or laboratory evidence of active nephritis, especially upon the first episode of nephritis.

  Lupus nephritis is staged according to the classification revised by the International Society of Nephrology (ISN) and the Renal Pathology Society (RPS) in 2003, as follows:

  Class I – Minimal mesangial lupus nephritis

  Class II – Mesangial proliferative lupus nephritis

  Class III – Focal lupus nephritis (active and chronic; proliferative and sclerosing)

  Class IV – Diffuse lupus nephritis (active and chronic; proliferative and sclerosing; segmental and global)

  Class V – Membranous lupus nephritis

  Class VI – Advanced sclerosis lupus nephritis

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