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Renal involvement in systemic diseases refers to kidney dysfunction or damage caused by underlying systemic conditions, often autoimmune or inflammatory disorders. The kidneys may be affected by immune complex deposition, vasculitis, or inflammation leading to various renal pathologies such as glomerulonephritis, tubulointerstitial nephritis, or thrombotic microangiopathy. Common systemic diseases causing renal involvement include systemic lupus erythematosus (SLE), systemic sclerosis (scleroderma), Sjögren syndrome, autoimmune myopathies, antiphospholipid syndrome, and rheumatoid arthritis.

In SLE, lupus nephritis is a major renal manifestation that requires biopsy-driven treatment to control inflammation and preserve kidney function. Scleroderma can cause renal crisis with malignant hypertension and acute kidney injury, requiring urgent management with ACE inhibitors. Sjögren syndrome mainly causes tubulointerstitial nephritis, while antiphospholipid syndrome can lead to thrombotic microangiopathy affecting renal vessels. Treatment of the underlying systemic disease often improves renal outcomes, but renal involvement is a critical factor affecting prognosis and requires careful monitoring and tailored therapy.

Thus, renal involvement in systemic diseases is diverse, reflecting the complex immunologic and vascular injury mechanisms triggered by the systemic condition, necessitating multidisciplinary approaches for diagnosis and management.?