Classes of Lupus

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Regular Member

Date Joined Aug 2007
Total Posts : 206
   Posted 5/21/2009 8:13 PM (GMT -6)   
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!
 "Challenges make you discover things about yourself you never really knew."
 SLE and Class II Lupus Nephritis

Veteran Member

Date Joined Jan 2005
Total Posts : 8616
   Posted 5/21/2009 8:37 PM (GMT -6)   
Hi Tammy,

I've heard of classification for the Lupus Nephritis. But IF I remember correctly, the classification wasn't a progressive thing . . . it was actually a "category". But not sure I'm remembering correctly. Have you looked on the site??? There is also an interesting website listed in Lupus Resources . . . providing a lupus algorithm questionnaire. It takes a while to work through it, but that might be interesting too.

I'll be watching for the posts in this topic . . . . interesting.


In His Grip

AlwaysRosie           "We can't control the waves, but we can learn how to surf!!"

Psalms 139

Co-Moderator - Lupus Forum

UCTD, Inflammatory Arthritis, Diverticulosis, (recent dx - Sjogrens, Crohn’s 4/08)

Clickable Links:  Lupus Resources    Lupous.Org   Lupus Criteria (4 of 11)   Lupus Chapter Locator

Regular Member

Date Joined Aug 2007
Total Posts : 206
   Posted 5/21/2009 8:46 PM (GMT -6)   
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.
 "Challenges make you discover things about yourself you never really knew."
 SLE and Class II Lupus Nephritis

Veteran Member

Date Joined Sep 2005
Total Posts : 2573
   Posted 5/21/2009 9:17 PM (GMT -6)   
I wish they had a classification system for lupus itself. I wonder if we all could come up with one? It might be fun to decide what belongs in what "class" then there are subclasses to consider as well. ;)
Dx:fibromyalgia 2002, systematic lupus 2005- definate CNS involvement dxed late 2005, psoriasis 2006, rheumatoid arthritis 2006, PTSD 2007, multiple allergies 2005, migraine, compression fractures T11 & T12, Sjögren's, damaged periphrial nerves 2007, exema
Tx: plaquenil, Enbrel, Tramadol, Singulair, Skelaxin, Baby Asprin, Imuran, Prilosec, lasix, Evoxac, Celebrex, Darvocet when things get too bad, prednisone again, various vitamin/mineral supplements, cozar

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Date Joined Apr 2006
Total Posts : 1344
   Posted 5/25/2009 12:06 PM (GMT -6)   
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*
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.


New Member

Date Joined Sep 2008
Total Posts : 11
   Posted 6/27/2009 2:04 PM (GMT -6)   

Hi Everyone,

I have just started reading about kidney involvement the first of June.

My 10yr was diagnosed last August and we just had significant amounts of protein found in her urine during the doctors appointment the first of June. She was scheduled for a kidney biopsy about a week later.  Yesterday we went to find the results for the biopsy and she is a CLASS V---membranous lupus nephritis.

When I first started reading about the classes (WHO)World Health Organization. It was confusing...was it how damaged the kidneys were, so if her last bloodwork showed no issues in February was I to expect closer to the Class 1 or Class 2....OR....did it depend on what area of the kidney that was affected.

The classes are dependent upon what part of the kidney is affected.

So when he came in and told us that he had GOOD NEWS for us (exhale) and then be told she was a CLASS V (inhale) I was confused.

But he said that it was better to be CLASS 1,2 or 5 then to be CLASS 3 or 4.

The CLASSES for Lupus Nephritis is different from the STAGES of GFR(g....... filtration rate).

My daughter has CLASS V but she is stage 1 on GFR scale. Her kidneys are not damaged but the GFR stages would increase if we did not take care of her kidney issues with the medication.

I hope that I am finally starting to put this together....????????


Veteran Member

Date Joined Jan 2005
Total Posts : 659
   Posted 7/1/2009 7:33 PM (GMT -6)   
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.

DX: Nephrotic Syndrome, Membranous Nephropathy (? Lupus Nephritis) 2002
DX: Raynaud's Phenomenon and Lupus (SLE & Class V Lupus Nephritis) 2005
DX: Anorexia and Hypokalemia 2006
DX: Hpercalcemia, Hyperparathyroidism, Gout 2009

Post Edited (curlyhair) : 7/1/2009 6:38:29 PM (GMT-6)

Veteran Member

Date Joined Dec 2005
Total Posts : 1950
   Posted 7/2/2009 12:13 AM (GMT -6)   
I have retroaortic left renal vein, which is supposed to be a finding in some cases of lupus nephritis and is indicative of some serious diseases, lupus being one of them. It is an interesting thing to read up on as far as being a predictor and it can be a finding on lumbar ct scans or mris. Its odd to think that our actual blood flow to the kidneys can be altered or deformed. When the abnormally routed vein becomes compressed you can get a variety of symptoms like blood in urine, pain and other things and they call it nutcracker syndrome. What makes me mad is that there are treatments if there is a problem. Because mydoc didn't see blood and protein in one quicky urine test, she would not refer me to a nephrologist, though I've had blood and protein in the past often and most of the other symptoms. Lots of times it is not even listed. I hope more is done to prevent kidney damage in the future. And I hope that your kidneys get better. It is a horrible pain and just can be maddening when it goes on a long time.
Love, Marji
Ills--Sjogrens-Lupus cond., AI polygland. dysfunction 2, hyper/hypopigment, scoliosis,kyphosis,stenosis, deg.,O.A.,spine surgeries, salivary/lymphectomies, NASH, COPD, RLS, UT/GI bleeds, hystero, brain/nerve damage,TB
Meds--INH,Plaquenil, Evoxac, Metformin, Synthroid, HCTZ, HRT and Lidocaine patchs, Voltaren gel, Klonopin, Vicodin, Restasis, Albuterol, steroids

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