Common complications of Lupus nephritis include microscopic hematuria, nephrotic syndrome, celluar casts, elevated creatnine and destruction of more than 50% of glomeruli.

Lupus nephritis may damage different parts of the kidney. Class I has normal histology and does not show any evidence of disease and class V shows an extensive disease.

• The symptoms of Lupus nephritis usually develop in one half of the patients with SLE and start with symptoms such as proteinuria.^[1][2][3]
• The symptoms of Lupus nephritis typically develop within three years after having SLE.^[3][4][5]
• If left untreated, thirty percent of patients with SLE may progress to develop hematuria, nephrotic syndrome, and hypertension.

Possible complications include:^[3]

• Interstitial nephritis
• Nephrotic syndrome
• Membranous glomerulonephritis^[5]
• Kidney failure – acute and chronic
• End stage renal disease
• Hypertension

• The class of lupus nephritis: Focal lupus nephritis, minimal mesangial lupus nephritis and mesangial proliferative lupus nephritis have better prognosis than other classes. And, advanced sclerosis lupus nephritis carries a poor prognosis.^[4]
• Nephrotic syndrome carries worse prognosis.^[5]
• Creatinine level: Patients with elevated creatinine (>3 mg/dL) at presentation have worse outcomes.^[5]
• Patients with persistently elevated anti-dsDNA and low C3 and C4 levels have poorer outcomes.
• Renal biopsy findings showing diffuse lupus nephritis or high chronicity index suggest worse prognosis.^[5][4]
• Young age onset carries worse prognosis.
• Male gender have poorer outcomes than female.^[4]
• Black race have worse outcomes than other races.^[4]
• Although lupus nephritis may return in a transplanted kidney, it rarely leads to end-stage kidney disease.^[5]

• Prognosis is generally poor for class IV, and the 50% survival is 15/+- 2.5 years.^[6][7]