Renal involvement in autoimmunity has many facets. Glomerular, tubular and vascular structures are targeted and damaged as a consequence of autoimmune processes. Immunologically mediated kidney diseases represent the third most common cause of end-stage renal failure (after diabetic and hypertensive nephropathies). Appropriate evalution of patients with immune-mediated kidney diseases requires a meticulous history and physical examination, with particular attention to the urinalysis, tests of renal function and often renal biopsy. The thorough clinician should personally review microscopic urinalysis in any case in which there is a reasonable index of suspicion of immune-mediated renal disease. In this article we propose to highlight recent developments, with particular reference to renal autoimmunity. Systemic lupus erythe-matosus affects many parts of the body: primarily the skin and joints, but also the kidneys. Goodpasture's syndrome involves an autoantibody that specifically targets the kidneys and the lungs. IgA nephropathy is a form of glomerular disease that results when immunoglobulin A (IgA) forms deposits in the glomeruli, where it creates inflammation. Future research could look for how the disease occurs, and how to easily test for its presence so that early treatment could be started.
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