Optimizing Outcomes in Lupus Nephritis Through Interdisciplinary Collaboration: The Intersection of Nursing, Family Medicine, Laboratory Science, and Medical Record Management
Abstract
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by immune complex deposition and multi-organ inflammation. Lupus nephritis (LN), a severe renal manifestation, is a leading cause of morbidity and mortality in SLE patients, with a significant risk of progression to end-stage renal disease (ESRD) if not managed promptly.
Aim: This article synthesizes the complex etiology, pathophysiology, and management of LN, with an implicit aim to underscore the necessity of a multidisciplinary, collaborative approach to optimize patient outcomes through early detection, precise diagnosis, and personalized treatment.
Methods: The review consolidates current medical literature on LN, detailing its pathogenesis involving genetic predisposition, environmental triggers, and immune dysregulation. It emphasizes the critical role of renal biopsy for histopathological classification (ISN/RPS system) and evaluation of activity/chronicity indices. The management framework is analyzed, outlining evidence-based protocols for induction and maintenance immunosuppressive therapy, risk-factor modification, and the integration of novel biologic agents.
Results: LN prognosis is highly dependent on timely intervention guided by histologic class. Proliferative forms (Classes III/IV) carry the poorest renal outcomes without aggressive treatment. Advances in therapy, including mycophenolate mofetil, belimumab, and voclosporin, have improved remission rates and enabled steroid-sparing strategies. However, outcomes are significantly influenced by factors such as ethnicity, access to care, and adherence to long-term maintenance therapy.
Conclusion: Effective management of LN requires an interdisciplinary model integrating rheumatology, nephrology, nursing, primary care, and laboratory science. This collaborative framework ensures vigilant surveillance, biopsy-informed treatment decisions, aggressive comorbidity management, and comprehensive patient education, ultimately leading to preserved renal function and improved quality of life.
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References
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