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New Guidelines Issued for Severe Lupus
Date:5/3/2012

By Serena Gordon
HealthDay Reporter

THURSDAY, May 3 (HealthDay News) -- When diagnosed with lupus, one in three people already has kidney inflammation, and during the first 10 years with the disease as many as 60 percent of patients will have some kidney problems.

Because kidney inflammation (also called lupus nephritis) is so common in people with lupus, the American College of Rheumatology has issued new guidelines for the screening and management of this potentially devastating complication of lupus.

"Without treatment, lupus nephritis can lead to end-stage-renal disease, which requires dialysis or a kidney transplant. But, not all types are this serious. It depends on the pattern of damage to the kidneys," said the lead author of the new guidelines, Dr. Bevra Hahn, a professor of medicine and chief of rheumatology at the David Geffen School of Medicine at the University of California, Los Angeles.

Hahn said the course of lupus nephritis can vary greatly from patient to patient. And, that means that treatment decisions need to be individualized.

The guidelines, released online May 3, will be published in the June issue of Arthritis Care & Research.

Lupus -- short for systemic lupus erythematosus (SLE) -- is a chronic autoimmune disease. That means that the body's immune system mistakenly attacks healthy cells in the body. The most commonly affected areas are the joints and skin, but lupus can affect any body part, including the kidneys. The disease is mild in some people and more severe in others. There are also symptom-free periods of time, and then the disease flares again.

If the kidneys are involved, quality of life and survival rates suffer. Normally, the survival rate is 92 percent after 10 years with lupus. If the kidneys are involved, survival drops to 88 percent, according to the guidelines. Blacks have an even lower survival rate when the kidneys are affected.

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