Lupus nephritis

Class	Clinical Clues	Treatment
Class I: minimal mesangial	Normal UA Normal creatinine Seen on biopsy	None
Class II: proliferative mesangial	Non-nephrotic proteinuria or microhematuria Normal creatinine	None
Class III: focal lupus nephritis	Proteinuria and hematuria ± hypertension ± renal dysfunction	Initial: steroids with cyclophosphamide or MMF Maintenance: AZT or MMF, ± steroids
Class IV: diffuse lupus nephritis	Proteinuria and hematuria Hypertension Renal dysfunction	Initial: steroids with cyclophosphamide or MMF Maintenance: AZT or MMF, ± steroids
Class V: membranous lupus nephritis	Proteinuria (± nephrotic) Normal creatinine ± microhematuria	Non-nephrotic: ACEi Nephrotic: ACEi with steroids and immunosuppression
Class VI: sclerosing lupus nephritis	Proteinuria Slowly progressive renal dysfunction	None