Classes of Lupus

Is anyone familiar with the classes of Lupus?  I know they are 1-5 with 4 and 5 being the most dangerous. But I don't understand if the numbering system has to do with the Nephritis or the actual Lupus.  I guess I thought if you had Lupus you had it.  A friend of mine is classified as a class 4, but she doesn't get if its the SLE part or the kidney part either.    I only ask because when I discussed trying to get off my metho with my rheumy today he mentioned that I'm "only a class II" but I don't know if he was thinking it over in his head because I want off the meds so I can start a family, or if he was telling me that its not that serious.  I can't imagine it not being serious because when I flare its horrible and painful and I swell up and I'm sick and he wants to monitor my bloodwork every 2 months and urine every 3 months.  I'm hoping someone can clear this up for me.  Thanks!

Thanks Rosie-I found it and there is a table that explains it. I'm thinking his concern with going off treatment was more about deciding what would happen to my kidneys. We discussed other things that could possibly go wrong should I ever get pregnant.

There is a rating system for the severity of kidney disease but it doesn't have anything to do with lupus, just kidneys.

Chronic kidney disease

Chronic kidney disease is when one suffers from gradual and usually permanent loss of kidney function over time. This happens gradually over time, usually months to years. Chronic kidney disease is divided into five stages of increasing severity (see Table 1 below). Stage 5 chronic kidney failure is also referred to as end-stage renal disease, wherein there is total or near-total loss of kidney function and patients need dialysis or transplantation to stay alive. The term "renal" refers to the kidney, so another name for kidney failure is "renal failure." Mild kidney disease is often called renal insufficiency.

Unlike chronic kidney disease, acute kidney failure develops rapidly, over days or weeks.

Acute kidney failure usually develops in response to a disorder that directly affects the kidney, its blood supply, or urine flow from it.

Acute kidney failure usually does not cause permanent damage to the kidneys. With appropriate treatment of the underlying condition, it is often reversible, with complete recovery.

In some cases, though, it may progress to chronic kidney disease.
For more, please read the Kidney Failure article.

Table 1. Stages of Chronic Kidney Disease

Stage Description GFR*
mL/min/1.73m2
1 Slight kidney damage with normal or increased filtration More than 90
2 Mild decrease in kidney function 60-89
3 Moderate decrease in kidney function 30-59
4 Severe decrease in kidney function 15-29
5 Kidney failure requiring dialysis or transplantation Less than 15
*GFR is glomerular filtration rate, a measurement of the kidney's function.



My kidney problems seemed very bad but a biopsy showed it was only stage 2 and after treatment with an ace inhibitor kidney function returned to normal. Have not had any problems whatsoever for almost 4 years but continue to take meds just in case.



Bill

Hi katalexanna,

I also have class V, membranous lupus nephritis. It seems to be a rarer form because I haven't found too many other people that have it. I have been in remission for several years but I am stage 3 on the GFR scale. Hopefully my kidneys will not deteriorate any more. Your daughter is young to have problems but her kidneys are in good shape (stage 1) and hopefully she will also go into remission. You are right that the different classifications can get confusing but you seem to understand it. Hope your daughter is doing well.

Sandy