Nefropatía lúpica

  • Ricardo Silvariño Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Centro de Nefrología, Departamento de Emergencia, Clínica Médica B.
  • Gabriela Ottati Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Centro de Nefrología.
  • Óscar Noboa Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Centro de Nefrología.
Palabras clave: NEFRITIS LÚPICA

Resumen

El compromiso renal es frecuente en el lupus eritematoso sistémico (28%-74%), constituyendo en algunas series el factor que se vincula a la mayor morbimortalidad asociada a la enfermedad. En su patogenia participan el depósito de inmunocomplejos, la activación del complemento, linfocitos B, T y múltiples citocinas. Se puede manifestar clínicamente con cualquier síndrome nefrológico, desde alteraciones mínimas del sedimento urinario a enfermedad renal crónica extrema. La biopsia renal está indicada en todas las circunstancias en que se sospeche el daño renal así como frente a cambios clínico-evolutivos en pacientes con nefropatía lúpica conocida. El tratamiento se planifica en función de la presentación clínica, lesión histológica predominante, compromiso extrarrenal, edad, comorbilidades y preferencias del paciente. Algunos factores como el retraso en el diagnóstico, la edad de presentación, características raciales, formas proliferativas, valor de creatinina y proteinuria al debut se vinculan a progresión hacia enfermedad renal crónica extrema. Se revisan los principales aspectos vinculados a la epidemiología, presentación clínica, lesión histológica y estrategias diagnósticas y terapéuticas en la nefropatía lúpica.

Citas

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Publicado
2015-03-31
Cómo citar
1.
Silvariño R, Ottati G, Noboa Óscar. Nefropatía lúpica. Rev. Méd. Urug. [Internet]. 31 de marzo de 2015 [citado 14 de julio de 2020];31(1):64-8. Disponible en: http://revista.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/227
Sección
Trabajos de Revisión o Actualización y Puestas al día

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