Quiz: True or False: ALL patients who have a diagnosis of SLE should be evaluated for lupus nephritis by checking the eGFR and the urine for both microscopy and urine albumin to creatinine ratio (uACR).

True

Diagnostic Testing for Lupus Nephritis in Newly Diagnosed Systemic Lupus Erythematosus (SLE)

In patients with systemic lupus erythematosus (SLE), the most appropriate diagnostic tests to perform to assess for lupus nephritis are urinalysis with microscopy and urine albumin to creatinine ratio (uACR). These tests are crucial in assessing kidney involvement, which is common in SLE and can significantly impact prognosis if left untreated.

Here are some key points regarding the importance of urine testing in diagnosing lupus nephritis:

Urinalysis and urine albumin to creatinine ratio are simple, inexpensive, and easily available tests that provide valuable information in patients with SLE.

Kidney involvement in SLE can range from mild proteinuria or hematuria to acute kidney injury, emphasizing the need for early detection and management.

Albumin in the urine should be quantified and trended over time to assess disease activity in SLE, making urinalysis and uACR crucial tools in monitoring disease progression.

Kidney biopsy may be necessary to grade the severity and evaluate the pattern of kidney involvement in SLE.

Therefore, in newly diagnosed SLE, urinalysis and urine albumin to creatinine ratio remain the cornerstone diagnostic tests to assess for kidney disease and guideline appropriate management strategies. A serum creatinine may also be of value.

Inspiration: MKSAP online