The course and treatment of lupus nephritis.

Abstract:

:Renal involvement by systemic lupus is variable; some patients have minimal clinical and histologic involvement, whereas others have fulminant renal failure and severe proliferative renal lesions on biopsy. The World Health Organization (WHO) classification has greatly aided in the study of lupus nephritis. This classification defines six major patterns of renal involvement, each with characteristic clinical correlates and a typical course and prognosis. Transformations from one pattern of lupus nephritis to another may occur, and there may also be prominent involvement of the tubulointerstitial compartment and vasculature. Treatment of the renal lesions may be directed at the individual class of lupus nephritis. Thus patients with mesangial involvement (WHO Class II) do not require therapy directed at their kidney lesions. Many patients with biopsies showing focal proliferative disease (WHO Class III) and all patients whose biopsies show diffuse proliferative lesions (WHO Class IV) require vigorous treatment, which has included high-dose daily and alternate-day corticosteroids, azathioprine, i.v. pulse methylprednisolone, plasmapheresis, total lymphoid irradiation, cyclosporine, and oral and i.v. cyclophosphamide. Controlled trials have yielded reasonable evidence for the safety and efficacy of some treatments, whereas others have been used only in uncontrolled studies. When used judiciously, such vigorous therapy can improve the renal survival of patients with severe lupus nephritis.

journal_name

Annu Rev Med

authors

Appel GB,Valeri A

doi

10.1146/annurev.med.45.1.525

subject

Has Abstract

pub_date

1994-01-01 00:00:00

pages

525-37

eissn

0066-4219

issn

1545-326X

journal_volume

45

pub_type

杂志文章,评审
  • The FDA critical path initiative and its influence on new drug development.

    abstract::Societal expectations about drug safety and efficacy are rising while productivity in the pharmaceutical industry is falling. In 2004, the US Food and Drug Administration introduced the Critical Path Initiative with the intent of modernizing drug development by incorporating recent scientific advances, such as genomic...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.59.090506.155819

    authors: Woodcock J,Woosley R

    更新日期:2008-01-01 00:00:00

  • Genetic testing in clinical practice.

    abstract::In the practice of internal medicine, the value of genetic testing in common (mono)genetic diseases such as familial hemochromatosis, hypercholesterolemia, Mediterranean fever, and thrombophilia is limited. The genotype insufficiently predicts the phenotype because of the powerful effects of other modifying genes, env...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.60.103007.132540

    authors: Lamberts SW,Uitterlinden AG

    更新日期:2009-01-01 00:00:00

  • Lymphatic mapping and sentinel lymph node biopsy in patients with breast cancer.

    abstract::The standard of care for the evaluation of axillary nodal involvement remains complete lymph node dissection. Lymphatic mapping and sentinel lymph node (SLN) biopsy are changing this long-held paradigm; indeed, several leading institutions already reserve complete axillary dissection for patients with metastasis to th...

    journal_title:Annual review of medicine

    pub_type: 杂志文章

    doi:10.1146/annurev.med.51.1.525

    authors: Cox CE,Bass SS,McCann CR,Ku NN,Berman C,Durand K,Bolano M,Wang J,Peltz E,Cox S,Salud C,Reintgen DS,Lyman GH

    更新日期:2000-01-01 00:00:00

  • Natural killer cells.

    abstract::Natural killer (NK) cells are a subpopulation of lymphocytes, with azurophilic granules in their cytoplasm, that have spontaneous cytotoxicity against a variety of tumor cells, virus-infected cells, and some normal cells in the bone marrow and thymus. When lymphocytes are cultured in the presence of interleukin 2 (IL ...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.37.020186.002023

    authors: Herberman RB

    更新日期:1986-01-01 00:00:00

  • Imaging of atherosclerosis.

    abstract::It is now well recognized that the atherosclerotic plaques responsible for thrombus formation are not necessarily those that impinge most on the lumen of the vessel. Nevertheless, clinical investigations for atherosclerosis still focus on quantifying the degree of stenosis caused by plaques. Many of the features assoc...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-041709-133809

    authors: Owen DR,Lindsay AC,Choudhury RP,Fayad ZA

    更新日期:2011-01-01 00:00:00

  • Acquired immunodeficiency syndrome: epidemiology, virology, and immunology.

    abstract::Acquired immunodeficiency syndrome indicates opportunistic infection or unusual malignancy associated with a marked deficiency of cell mediated immunity in the absence of any other cause of the immune defect. This review examines epidemiology, virology, and immunology associated with this disorder. The syndrome appear...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.36.020185.002553

    authors: Weiss A,Hollander H,Stobo J

    更新日期:1985-01-01 00:00:00

  • Adjuvant Bisphosphonates and Breast Cancer Survival.

    abstract::Randomized trials have studied bisphosphonates in the adjuvant setting of early breast cancer to investigate their ability to prevent treatment-induced bone loss. Trial results have also suggested their potential to prevent disease recurrence and metastases. These trials are summarized in this review. A recent patient...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-053014-103600

    authors: Strobl S,Korkmaz B,Devyatko Y,Schuetz M,Exner R,Dubsky PC,Jakesz R,Gnant M

    更新日期:2016-01-01 00:00:00

  • Fatal asthma.

    abstract::This brief review highlights the rise in asthma mortality witnessed in many countries. It outlines the multifactorial character of this phenomenon, which in most instances is a complex interplay between physician, patient, and environment. The pathophysiology of airflow obstruction and in particular the role of hyperi...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.47.1.161

    authors: FitzGerald JM,Macklem P

    更新日期:1996-01-01 00:00:00

  • Mediators of ischemic renal injury.

    abstract::Acute renal failure is a serious consequence of renal ischemia. The diagnosis carries an associated high mortality rate. When blood flow to the kidneys is inadequate to supply metabolic demands, a number of pathophysiological changes occur that ultimately result in cell death and tissue dysfunction, characterized by a...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.39.020188.002531

    authors: Bonventre JV

    更新日期:1988-01-01 00:00:00

  • Clonality in acquired hematologic disorders.

    abstract::Clonal populations of cells can be identified by a number of different independent approaches, including analyses of karyotype, gene rearrangements, deletions or point mutations, X-linked polymorphisms, and integration of virus into the genome. Assessment of clonality has yielded valuable and surprising clues to the p...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.42.020191.002423

    authors: Gilliland DG,Blanchard KL,Bunn HF

    更新日期:1991-01-01 00:00:00

  • Endothelial-leukocyte adhesion molecules in human disease.

    abstract::An effective host response to infection or tissue damage requires focal accumulation of leukocytes. Leukocyte adhesion to the vessel wall, a key step in this process, depends on the ordered expression of specific endothelial cell surface molecules. The endothelial molecules that support adhesion include selectins that...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.45.1.361

    authors: Bevilacqua MP,Nelson RM,Mannori G,Cecconi O

    更新日期:1994-01-01 00:00:00

  • Gonadotropin-releasing hormone and its analogs.

    abstract::GnRH and its analogues have led to exciting new avenues of therapy in virtually every subspecialty of internal medicine as well as in gynecology, pediatrics, and urology. Since their discovery in 1971, it has been demonstrated that GnRH and its analogues enable medical professionals to influence the hypothalamic-pitui...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.45.1.391

    authors: Conn PM,Crowley WF Jr

    更新日期:1994-01-01 00:00:00

  • Middle East Respiratory Syndrome: Emergence of a Pathogenic Human Coronavirus.

    abstract::In 2012, a zoonotic coronavirus was identified as the causative agent of Middle East respiratory syndrome and was named MERS coronavirus (MERS-CoV). As of August 11, 2016, the virus has infected 1,791 patients, with a mortality rate of 35.6%. Although MERS-CoV generally causes subclinical or mild disease, infection ca...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-051215-031152

    authors: Fehr AR,Channappanavar R,Perlman S

    更新日期:2017-01-14 00:00:00

  • Management of adult idiopathic thrombocytopenic purpura.

    abstract::Idiopathic thrombocytopenic purpura (ITP) is a common hematologic disorder manifested by immune-mediated thrombocytopenia. The diagnosis remains one of exclusion, after other thrombocytopenic disorders are ruled out based on history, physical examination, and laboratory evaluation. The goal of treatment is to raise th...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.56.082103.104644

    authors: Cines DB,McMillan R

    更新日期:2005-01-01 00:00:00

  • Progress in antisense technology.

    abstract::Antisense technology exploits oligonucleotide analogs to bind to target RNAs via Watson-Crick hybridization. Once bound, the antisense agent either disables or induces the degradation of the target RNA. Antisense agents can also alter splicing. During the past decade, much has been learned about the basic mechanisms o...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.55.091902.104408

    authors: Crooke ST

    更新日期:2004-01-01 00:00:00

  • The significance of electrocardiographic late potentials: predictors of ventricular tachycardia.

    abstract::Cardiac late potentials are observed by using a high-resolution, computer-processed ECG that can detect very low-level signals not seen with standard ECG techniques. Numerous clinical studies have demonstrated that patients with low-level signals after the QRS complexes (late potentials) are at much higher risk of ven...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.43.020192.001105

    authors: Berbari EJ,Lazzara R

    更新日期:1992-01-01 00:00:00

  • Paget's disease of bone.

    abstract::Paget's disease affects approximately 3% of the population over age forty. It may be genetically transmitted (autosomal-dominant), but recent evidence suggests a viral etiology. Effective agents for control of the disorder have been developed over the past decade, but all have significant drawbacks. Calcitonin tends t...

    journal_title:Annual review of medicine

    pub_type: 杂志文章

    doi:10.1146/annurev.me.28.020177.001043

    authors: Ryan WG

    更新日期:1977-01-01 00:00:00

  • Cardiovascular effects of tricyclic antidepressants.

    abstract::Overdoses of tricyclic antidepressants (TCAs) leave no doubt that TCA drugs at high concentrations have serious cardiac effects. It has been assumed that, to a lesser extent, these effects will occur at usual therapeutic concentration. Recent prospective, plasma-level-controlled studies have improved our understanding...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.35.020184.002443

    authors: Glassman AH

    更新日期:1984-01-01 00:00:00

  • MicroRNAs in Cancer.

    abstract::MicroRNAs (miRNAs) are small, noncoding RNAs with important functions in development, cell differentiation, and regulation of cell cycle and apoptosis. MiRNA expression is deregulated in cancer by a variety of mechanisms including amplification, deletion, mutation, and epigenetic silencing. Several studies have now sh...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.59.053006.104707

    authors: Garzon R,Calin GA,Croce CM

    更新日期:2009-01-01 00:00:00

  • Recent advances in surgery for emphysema.

    abstract::Volume reduction surgery is based on the removal of volume-occupying but nonfunctioning emphysematous lung, which is thought to improve pulmonary elastic recoil. The reduction in thoracic volume may also improve thoracic cage and inspiratory muscle function. In addition, dyspnea is lessened, exercise tolerance is incr...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.48.1.387

    authors: Lefrak SS,Yusen RD,Trulock EP,Pohl MS,Patterson A,Cooper JD

    更新日期:1997-01-01 00:00:00

  • Significance of diastolic dysfunction of the heart.

    abstract::Diastolic dysfunction is an important cause of the clinical syndrome of congestive heart failure. Traditionally, the syndrome of pulmonary congestion due to the elevation of left heart filling pressure has been attributed to the depressed ability of the heart to eject blood during systole, with a secondary increase in...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.42.020191.002211

    authors: Lorell BH

    更新日期:1991-01-01 00:00:00

  • Basket Studies: Redefining Clinical Trials in the Era of Genome-Driven Oncology.

    abstract::Understanding a tumor's detailed molecular profile has become increasingly necessary to deliver the standard of care for patients with advanced cancer. Innovations in both tumor genomic sequencing technology and the development of drugs that target molecular alterations have fueled recent gains in genome-driven oncolo...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-062016-050343

    authors: Tao JJ,Schram AM,Hyman DM

    更新日期:2018-01-29 00:00:00

  • Chemokine antagonists as therapeutics: focus on HIV-1.

    abstract::Human immunodeficiency virus type 1 (HIV-1) entry into target cells is a multistep process involving the interaction of viral envelope proteins with cell surface receptors. Binding to CD4 is followed by engagement of specific chemokine receptors (CCR5 or CXCR4), triggering molecular rearrangements in the envelope tran...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.58.080105.102908

    authors: Tsibris AM,Kuritzkes DR

    更新日期:2007-01-01 00:00:00

  • CCR5 antagonism in HIV infection: current concepts and future opportunities.

    abstract::CCR5 antagonists inhibit HIV-1 entry by blocking the interaction of HIV-1 with the CCR5 cellular receptor. In patients with established HIV-1 infection, some viral strains use an alternative coreceptor for HIV-1 entry, CXCR4; CCR5 antagonists are not effective in patients harboring these viral strains. Coreceptor trop...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-052010-145454

    authors: Wilkin TJ,Gulick RM

    更新日期:2012-01-01 00:00:00

  • Hepatitis E: an overview.

    abstract::Hepatitis E has a worldwide distribution and causes substantial morbidity and mortality in some developing countries, particularly among pregnant women. Hepatitis E virus (HEV) has recently been cloned and sequenced and new diagnostic tests have been developed; these tests have been used to begin to characterize the n...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.47.1.257

    authors: Mast EE,Krawczynski K

    更新日期:1996-01-01 00:00:00

  • Update on typical and atypical antipsychotic drugs.

    abstract::Antipsychotic drugs (APDs) are best classified as typical or atypical. The distinction is based solely on their ability to cause extrapyramidal side effects (EPS), including tardive dyskinesia (TD). The two classes differ in mechanism of action, with atypical APDs providing important modulation of serotonergic neurotr...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-050911-161504

    authors: Meltzer HY

    更新日期:2013-01-01 00:00:00

  • Progress toward an HIV vaccine.

    abstract::The development of an HIV vaccine is proving to be an unprecedented challenge. The difficulty in creating this vaccine arises from the enormous genetic variation of the virus and the unusual importance of cytotoxic T lymphocytes (CTL) in controlling its spread. Whereas traditional vaccine strategies are unlikely to co...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.54.101601.152349

    authors: Letvin NL

    更新日期:2005-01-01 00:00:00

  • Barrett's Esophagus and esophageal adenocarcinoma.

    abstract::The incidence of esophageal adenocarcinoma (EAC) has risen dramatically over the past three decades in western countries. The importance of Barrett's esophagus (BE) derives from its potential to transform to adenocarcinoma. BE is characterized by endoscopically recognized displacement of the squamocolumnar junction pr...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.59.061206.112706

    authors: Bresalier RS

    更新日期:2009-01-01 00:00:00

  • Calorie restriction, aging, and cancer prevention: mechanisms of action and applicability to humans.

    abstract::Calorie restriction (CR) is the most effective and reproducible intervention for increasing lifespan in a variety of animal species, including mammals. CR is also the most potent, broadly acting cancer-prevention regimen in experimental carcinogenesis models. Translation of the knowledge gained from CR research to hum...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.54.101601.152156

    authors: Hursting SD,Lavigne JA,Berrigan D,Perkins SN,Barrett JC

    更新日期:2003-01-01 00:00:00

  • Cellular action of calcium channel blocking drugs.

    abstract::The calcium antagonists are an exciting "class" of drugs that are already making an important impact in the treatment of coronary artery disease. All three drugs in use in the US, verapamil, nifedipine, and diltiazem, are effective coronary vasodilators. In addition, verapamil and diltiazem have antiarrhythmic activit...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.35.020184.001545

    authors: Schwartz A,Triggle DJ

    更新日期:1984-01-01 00:00:00