Lupus classification system too complicated

The current classification system for kidney complications in patients with lupus is too detailed, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). The results should make it easier for physicians to classify and treat kidney problems in patients with the disease.

People with the autoimmune disease (lupus) can experience a number of medical complications, including lupus nephritis, an inflammatory . Lupus nephritis affects approximately 3 out of every 10,000 people, and it can be serious and lead to .

Classifying the severity of patients' lupus nephritis can help physicians choose appropriate therapies. The World Health Organization created a classification system that divided cases into six classes based on severity, and in 2003, the International Society of Nephrology and the Renal Pathology Society proposed some revisions. One of the most important changes subdivided class IV (when 50% or more of the kidney is diseased) into a segmental form and a global form depending on exactly how much of the kidney is affected.

This new classification of class IV lupus nephritis resulted from a study of 86 patients that suggested a difference in health outcomes, such as kidney failure, between those with segmental and global forms of the disease.

After the new classification system was published, various studies came to contradictory conclusions about differences in the health outcomes of patients in the two class IV groups. To provide some insight, Jo Berden, MD, PhD, Catharina Haring, MD (Radboud University Nijmegen Medical Center, in Nijmegen, The Netherlands), and their colleagues searched the medical literature and analyzed all of the studies and clinical trials that used the 2003 International Society of Nephrology and Renal Pathology Society classification of lupus nephritis in adult patients.

In the eight studies included in the final analysis, the incidence of kidney failure varied between 0% and 67%. The analysis did not support a significant difference in kidney outcomes between the segmental and global subclasses.

The results suggest the current classification system is too detailed. "This research is important because it could make the categorization of easier and more comprehensive," said Dr. Berden.

More information: The article, entitled "Segmental and Global Subclasses of Class IV Lupus Nephritis Have Similar Renal Outcomes," will appear online on Thursday, October 27, 2011, doi:10.1681/ASN.2011060558

add to favorites email to friend print save as pdf

Related Stories

Kidney transplants generally safe for lupus patients

Nov 02, 2009

Individuals with a history of lupus who receive a kidney transplant rarely develop the serious inflammatory condition lupus nephritis in their new organ, according to a paper being presented at the American Society of Nephrology's ...

Rituximab reduces kidney inflammation in patients with lupus

Mar 04, 2009

Treatment with the targeted drug rituximab can significantly benefit some patients with severe lupus nephritis who do not respond to conventional therapy, according to a study appearing in an upcoming issue of the Clinical Jo ...

Alternative therapy for lupus nephritis

Apr 15, 2009

Lupus is a rare but serious disease that mainly affects women of child-bearing age and occurs when the body's immune system goes awry, damaging a variety of organs. When kidneys are targeted, patients develop lupus nephritis, ...

Recommended for you

Mali announces new Ebola case

16 hours ago

Mali announced Saturday a new case of Ebola in a man who is fighting for his life in an intensive care unit in the capital Bamako.

Plague outbreak kills 40 in Madagascar: WHO

16 hours ago

An outbreak of plague has killed 40 people in Madagascar, the World Health Organization said, warning that the disease could spread rapidly in the country's densely populated capital Antananarivo.

UN chief: Ebola cases in Mali a 'deep concern'

Nov 21, 2014

The United Nations chief warned Friday that Ebola may be easing in part of West Africa but is still hitting hard in other areas and outpacing the international response.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.