Following are the classes of Lupus Nephritis:
The World Health Organization has divided lupus nephritis into five classes based on the biopsy:
Class I is histologically normal and does not show any evidence of disease.
Class II is based on a finding of mesangial lupus nephritis. This form typically responds completely to treatment with corticosteroids.
Class III is focal proliferative nephritis and often successfully responds to treatment with high doses of corticosteroids.
Class IV is diffuse proliferative nephritis. This form is mainly treated with corticosteroids and immunosuppressant drugs.
Class V is membranous nephritis and is characterized by extreme edema and protein loss.
Class VI is Glomerulosclerosis (scarring of the kidneys' tiny blood vessels, the glomeruli. One sign of glomerulosclerosis is proteinuria (larger amounts of protein appearing in the urine) because the scarring disturbs the kidneys' filtering process and allows protein to leak from the blood into the urine). Scarred glomeruli cannot be repaired. Many patients with glomerulosclerosis may get worse until their kidneys fail completely. This condition is called end-stage renal disease or ESRD. Patients with ESRD must go on dialysis (hemodialysis or peritoneal dialysis) to clean their blood or get a new kidney through transplantation. The best treatment for glomerulosclerosis depends upon what caused the scarring. This is determined by renal biopsy. Immunosuppressants -- drugs that block the body's immune system -- stop proteinuria in about half of the patients with glomerulosclerosis. But when the course of treatment is over, proteinuria may return for many patients. In some cases, the drugs actually may end up hurting the kidneys of certain patients.
Most doctors try to slow down the progression of kidney failure by controlling the patient's blood pressure. This is one of the most important tools available. A class of blood pressure medicines called ACE inhibitors appears to preserve kidney function in patients with diabetes. Further studies may show that ACE inhibitors slow down kidney failure even in patients who do not have diabetes. Some doctors advise their patients to go on a low-protein diet to lighten the load of wastes on the kidneys. Some kidney patients may need to control their cholesterol through diet or both diet and medicine.
Here is a brief explanation of some of the terms used above:
Diffuse = not concentrated or localized
Diffuse Proliferative Nephritis = a term used to describe a distinct histologic (The microscopic structure of tissue from biopsy)form of glomerulonephritis (a type of kidney disease caused by inflammation of the internal kidney structures known as glomerul) common to various types of systemic inflammatory diseases like Lupus. More than 50% of the glomeruli (diffuse) demonstrate increased mesangial (specialized cells around blood vessels in the kidneys), epithelial (epithelial tissues are found on a surface of organs -They are distinguished from each other by their differences in cell shape and cell orientation. In all cases the cells are tightly connected), endothelial ( the thin layer of cells that line the interior surface of blood vessels), and inflammatory cells (ie, glomerulonephritis).
When fewer than 50% of the glomeruli are involved, the condition is termed focal proliferative and has the potential to progress to Diffuse Proliferative Glomerulonephritis. The diagnosis is often suspected in a patient presenting with systemic inflammatory disease (such as Lupus) who manifests hematuria(blood in the urine), proteinuria (protein leak in the urine), and active urinary sediment (which red cells, white cells, oval fat bodies, and all types of casts are found) or azotemia (ie, rise in serum blood urea nitrogen, creatinine); histologic findings from kidney biopsy tissue are used to confirm the diagnosis.
You have been diagnosed with mixed symptoms of stage 3 and 5 because you have protein leakage, blood in your urine, scarring, and blockage (a combination of symptoms in class 3 and 5). Your course of treatment (as outlined above) is standard for the symptoms you are exhibiting.
I hope that I've answered your question. Please let me know if you need anything further in the way of explanations.
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