UF Health MedMatters

UF Health offers multidisciplinary care for lupus nephritis in long-established joint clinic

Lupus nephritis is a complication of systemic lupus erythematosus, or SLE, that can trigger inflammation and cause tissue damage in the kidneys. This autoimmune disease can cause blood or a foamy appearance in the urine, body swelling and high blood pressure.

Due to the multisystem attack on healthy tissue, effective treatment for this kidney disease requires a multispecialty approach. Mark Segal, MD, PhD, a key member of the UF Health joint lupus nephritis clinic, staffed with a multidisciplinary team of specialists from the UF College of Medicine’s division of nephrology, hypertension & renal transplantation and the division of rheumatology and clinical immunology.

Segal specializes in treating lupus nephritis. He explained that his initial clinical interest in this area was sparked during his fellowship at Boston’s Beth Israel Deaconess Medical Center when he treated an 18-year-old patient with class IV lupus nephritis. Segal performed his first renal biopsy on the young patient and followed her for over a year as her renal function improved.

“We were able to manage her disease and make her feel better,” Segal said.

According to Segal, 50% of those diagnosed with lupus will experience some type of effect on their kidneys. UF’s joint lupus nephritis rheumatology clinic aims to provide a multispecialty approach to treatment options.

Westley Reeves, MD, a professor in the UF College of Medicine and chair of rheumatology and clinical immunology, approached Segal in 2001 about starting the joint clinic. Segal initially saw a small number of patients, but over time the number of patients has grown and now the clinic receives numerous referrals from through-out the state and the Southeast.

“It is a pleasure to take care of these patients and, together, manage their multiple medical problems to provide the highest quality of life we can offer to them,” he said.

Segal also explained the necessity for subspecialized treatment of lupus nephritis. Unlike many kidney diseases, an individual with lupus nephritis can have minimal systemic findings on laboratory testing, yet a kidney biopsy might reveal a severe case of lupus nephritis.

According to Segal, Reeves felt his patients were not being biopsied as aggressively as he wanted. This inspired Reeves to create the clinic with Segal.

“I think it is important for someone with lupus to be treated by someone who specializes in lupus nephritis to be certain that the patient is being biopsied at the right aggressiveness and being treated appropriately,” Segal said.

Segal is the only doctor who specializes in lupus nephritis at UF’s joint clinic. However, there are numerous rheumatologists who also work at the clinic.

The patients, he noted, appreciate being able to be seen by two physicians during one visit.

“The coordinated, complementary care between myself and the rheumatologists provides overall great treatment for the patients,” Segal said.

About UF Health Shands Hospital

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University of Florida Health Shands Hospital has been recognized among the nation’s best hospitals in seven adult medical specialties. Overall, UF Health Shands Hospital was recognized as one of the best hospitals in Florida. In addition to being ranked among the nation’s top 50 hospitals in seven specialties, UF Health Shands Hospital also was listed as “high performing” in seven specialties, including abdominal aortic aneurysm repair, colon cancer surgery, COPD, heart failure, lung cancer surgery, neurology & neurosurgery and orthopaedics.