Diagnostic Criteria for Lupus Podocytopathy

Diagnostic criteria - all of the following:

(1) presence of SLE with nephrotic range proteinuria; often accompanies by acute kidney injury; no history of nephrotoxic medications prior to onset

(2) light microscopy shows glomerular minimal change, mesangial proliferation or focal segmental glomerulosclerosis (FSGS). Exclusions: subepithelial or subendothelial deposits; endocapillary proliferation, necrosis and/or crescents.

(3) absence of capillary immune deposition on immunofluorescence with or without immunoglobulin and complement deposits in the mesangium

(4) foot process effacement > 50% on electron microscopy (typically >= 70%); may show mesangial dense deposits; subepithelial and subendothelial dense deposits absent