Lupus Nephritis is a severe and potentially life-threatening manifestation of systemic lupus erythematosus (SLE) in which immune-mediated inflammation damages kidney tissue. It is one of the most common causes of kidney disease in young adults, particularly women, and requires early diagnosis and aggressive management to prevent irreversible renal damage. In the UAE, lupus nephritis represents a major burden in tertiary nephrology care.
The condition develops when autoantibodies form immune complexes that deposit within the glomeruli, triggering inflammation, complement activation, and progressive scarring. Lupus nephritis can involve multiple compartments of the kidney, including the glomeruli, tubules, interstitium, and blood vessels. The severity and pattern of involvement vary widely, necessitating careful classification to guide treatment.

Clinical presentation ranges from mild urinary abnormalities to rapidly progressive kidney failure. Patients may experience swelling, hypertension, blood or protein in the urine, fatigue, and declining kidney function. In some cases, kidney involvement may be detected during routine monitoring of lupus patients before symptoms develop.

Diagnosis requires a combination of blood tests, urine analysis, immunological markers, and kidney biopsy. Biopsy is essential to classify the type of lupus nephritis, assess disease activity, and determine prognosis. Early diagnosis allows timely initiation of therapy, which is critical for preserving kidney function.

Management focuses on controlling immune-mediated inflammation and preventing progression to chronic kidney disease. Treatment typically involves immunosuppressive therapy tailored to disease severity, along with supportive measures such as blood pressure control and reduction of proteinuria. Close monitoring is required to balance disease control with treatment-related risks.
Lupus nephritis is characterized by periods of remission and relapse. Long-term follow-up with a nephrologist is essential to monitor kidney function, detect flares early, and adjust therapy as needed. With early intervention and appropriate management, many patients achieve sustained remission and maintain stable kidney function.