Mini-Symposium: Pathology of Medical Renal DiseaseRenal involvement in systemic lupus erythematosus: glomerular pathology, classification, and future directions

Systemic lupus erythematosus is a common cause of glomerulonephritis. Despite improvements in the management of lupus nephritis, about 10-30% of patients develop end-stage kidney disease within 15 years. The renal biopsy provides crucial information to the clinician, as the choice of treatment is guided by the histopathologic findings. The light microscopic appearances and clinical features of patients with systemic lupus erythematosus can vary considerably, reflecting the many patterns of histopathologic injury seen in this glomerulonephritis. This review illustrates the glomerular pathology and pathogenesis of lupus glomerulonephritis, and will focus on the most recent classification, the International Society of Nephrology/Renal Pathology Society (ISN/RPS) 2003 Classification of Lupus Nephritis.