To understand the pathophysiology, I would advise the reader to have a basic immunology text to hand. There is probably a greater emphasis on diagnosis and less on management and patient education than might be found in a similar UK journal article. This review article provides a substantive overview of Lupus Nephritis (LN) and, to a lesser degree, Systemic Lupus Erythematosus (SLE). It details its pathophysiology, diagnosis and management.

The pathophysiologies of SLE and LN are explored in great detail and, to the nurse unversed in immunology and auto-immune disease, this could be heavy going. While there is a helpful diagram of a Bowman's Capsule, with a review of its function, there are no diagrams to illustrate the immunology and/or a glossary of terms, which might have made for easier reading.

There is good linking of the immunology with the renal pathology. The diagnostics are also extensively described and include the differential diagnosis of SLE. The standard 1982 American Rheumatology Association criteria are clearly tabulated, as is the World Health Organization classification of renal pathology in SLE.

Management is well covered although, while acknowledging that there is controversy over the place of renal biopsy, the authors only outline the arguments in favour of this.

Pharmacological therapy and renal transplantation are covered including discussion of possible drug side-effects. The authors also cover patient education, general health maintenance, psychosocial issues, and prognosis -- but in less detail.

I recommend this article published in ANNA for its very thorough review of LN but, to understand the pathophysiology, I would advise the reader to have a basic immunology text to hand. There is probably a greater emphasis on diagnosis and less on management and patient education than might be found in a similar UK journal article.

Althea Mahon