SLE is a complex autoimmune disease that causes damage to several organs in the body, with the kidneys bearing the brunt of the disease. How to find out if the kidneys have been attacked by the disease? Does the presence of lupus nephritis mean that the disease is serious and what medications should be taken to treat it? Systemic lupus erythematosus is an autoimmune disease with multi-system and multi-organ damage, and multiple auto-antibodies can be detected in the body. The disease is mostly seen in young women, with complex and diverse clinical manifestations, mostly with insidious onset and a prolonged and recurrent course. The first symptoms may include joint pain, rash, hematologic changes (leukocytosis or thrombocytopenia), renal lesions, and abnormalities in the digestive system, nervous system, heart, and lungs. The kidney is one of the most commonly involved organs in SLE, and 50-70% of patients can develop clinical signs of kidney damage during the course of the disease, i.e. lupus nephritis. If a kidney biopsy is performed, pathological changes in the kidney can be detected in almost all patients. Lupus nephritis is a chronic process, and symptoms may be mild or severe. In mild cases, there may be no symptoms or only microscopic hematuria, proteinuria, or increased blood pressure and nocturia. In severe cases, there is massive proteinuria, hypoproteinemia and edema, hypertension and renal function impairment. The severity of lupus nephritis affects the prognosis of the disease, and uremia is a serious complication of SLE and one of the leading causes of death in SLE patients. Although there is no cure for lupus, once diagnosed, appropriate methods should be selected and active treatment can lead to remission. Therefore, emphasis should be placed on early diagnosis and early treatment of lupus, timely understanding of the extent and degree of lesion involvement and disease activity, and formulation of reasonable treatment plans. Glucocorticoids are the most important drugs for the treatment of lupus erythematosus and have anti-inflammatory and immunosuppressive effects. Depending on the severity and activity of the patient’s disease, the dose of hormones can be chosen differently: for patients with mild symptoms and no obvious visceral damage in the early stage, antimalarial drugs (chloroquine or hydroxychloroquine) and small doses of glucocorticoids (prednisone ≤10mg/d) can be used to help control the disease. In addition to glucocorticoids (0.5-1 mg kg-1 d-1), other immunosuppressive drugs such as azathioprine, methotrexate and leflunomide should be used in combination in patients with moderately active lupus. In the advanced stage of lupus nephritis lesions, patients’ renal function is severely impaired, and they will have large amounts of urine protein, elevated blood creatinine, edema, hypertension as well as hypoproteinemia and nephrotic syndrome, and the most serious consequences may lead to renal failure or even uremia. To avoid further deterioration of the disease, the induction of remission in severe active lupus should be rapidly controlled to stop or reverse visceral damage and strive for complete remission of the disease. Patients need to take glucocorticoids such as prednisone 1mg/ kg once a day, and gradually reduce the dose and maintain it in small doses (<10mg) 2 weeks after the disease is stabilized or within 8 weeks of treatment. If the symptoms are not easily controlled, high-dose hormones (500-1000mg), high-dose immune preparations (cyclophosphamide), and high-dose gammaglobulin shock therapy can be administered intravenously. After the disease is stabilized, the dosage of hormone is gradually reduced and the treatment is continued with maintenance dosage - maintenance dosage is the minimum dosage required to suppress the disease activity and maintain the continuous stability of the clinical condition, and the dosage varies from person to person, usually 10-15mg/d for a long period of maintenance. Immunologic agents, such as rhodopsin, azathioprine, cyclosporine (CsA), and morte-macrolide (i.e., primaquine), are also available and need to be selected according to the patient's condition. If the above treatments are not effective, rituximab (anti-CD20 monoclonal antibody), a biological agent, can also be used as a form of treatment for lupus nephritis. This treatment is fast-acting and has few side effects, but the biggest disadvantage is that it is very expensive, requires out-of-pocket payments, and is only used in patients with severe lupus nephritis who are not well treated with hormones and immunosuppressive drugs. Alternatively, treatments such as plasma exchange can be used. Lupus nephritis is prone to recurrent attacks, and patients' self-conscious symptoms are often less obvious. Doctors need to monitor patients regularly for changes in their condition and the effects and side effects of drug therapy. Patients need to review blood and urine routine, liver and kidney function in 2-4 weeks, and serological examination every 3-6 months. If urine protein increases, 24-hour urine protein >1g or blood creatinine (Scr) >5mg/dl, positive urine sediment (+), elevated anti-ds-DNA antibody, decreased complement (C3, C4), with extra-renal activity manifestation, it indicates disease activity. The dosage should be adjusted according to the disease at any time. Although glucocorticoids can reduce the symptoms and control the disease, they have side effects such as obesity, full-moon face, hypertension, increased blood glucose, and ease of infection and osteoporosis. Therefore, during the period of hormone administration, patients should be closely observed for changes in symptoms and timely supplementation of calcium and alfa D3 alcohol to prevent secondary osteoporosis. After the disease is controlled and improved, the hormone dosage will be gradually reduced and the side effects will be alleviated. SLE is a complex autoimmune disease. In order to achieve full control of the disease, patients need to work closely with rheumatologists in regular hospitals to stop the progress of the disease and protect important organs from damage by taking long-term medication. Patients with kidney damage do not have to worry too much, as adhering to standardized treatment can effectively control the progress of the disease and maintain a normal life including fertility; however, if they do not follow medical advice, stop taking medication without authorization or believe in prescriptions, making the disease recurring, it is likely to lead to the occurrence of uremia eventually.