Liječnički vjesnik, Vol. 136 No. 7-8, 2014.
Review article
RENAL TRANSPLANTATION IN PATIENTS WITH LUPUS NEPHRITIS
Lea Katalinić
Emma Eliasson
Ljubica Bubić-Filipi
Petar Kes
Branimir Anić
Nikolina Bašić-Jukić
Abstract
Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus (SLE), associated with high morbidity and mortality. Up to 60% of SLE patients develop LN, and despite novel and potent therapeutic regimens, 5 to 22% develop end-stage renal disease within 15 years of diagnosis. While LN primarily affects younger individuals, it is important to choose optimal method of renal replacement therapy for those who develop end-stage renal disease. Numerous studies were carried out trying to solve problems of treatment of patients with LN. Increased risk of infections, disease recurrence in renal allograft, undefined criteria for follow-up of disease activity after transplantation, as well as higher incidence of rejection episodes and thrombotic events are well known risks which have postponed and restricted access to transplantation for patients with LN for long-time. However, numerous studies have demonstrated similar long-term survival in patients treated with haemodialysis or peritoneal dialysis, with clear superiority of renal transplantation regarding the prolonged survival and better quality of life for SLE patients. Many questions are still waiting for answers. Close cooperation between nephrologists and immunologists provides the best treatment for SLE patients with end-stage renal disease.
Keywords
Lupus nephritis – complications, surgery; Kidney failure, chronic – etiology, surgery; Lupus erythematosus, systemic – complications; Kidney transplantation – adverse effects, immunology; Graft rejection – etiology; Thrombosis – etiology; Treatment outcome; Survival rate
Hrčak ID:
172620
URI
Publication date:
27.8.2014.
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