Systemic lupus erythematosus (SLE) is an autoimmune disease that results in chronic inflammation and damage of more than one organ. It is diagnosed clinically and serologically with the presence of autoantibodies. "Lupus" is a Latin term meaning "wolf," since one of the hallmark facial SLE rashes is similar to the bitemark of a wolf. In 400 BC, the "father of medicine," Hippocrates, was the first to document a case of lupus. In 1700 to 1800s, lupus was debated on whether it was associated with tuberculosis versus syphilis. Lupus evolved from being viewed as solely a dermatologic manifestation into an evolving multisystemic disease. One common manifestation that should be monitored for in SLE is involvement of the kidneys, known as lupus nephritis (LN). Lupus nephritis typically occurs after at least three years since the onset of SLE. Monitoring for development of lupus nephritis is done with serial creatinine, urine albumin-to-creatine ratio, and urinalysis. This evaluates if there is a rise in creatinine value from baseline creatinine and for the presence of proteinuria seen with lupus nephritis. Since lupus nephritis carries a high risk for increased morbidity, treatment plays an important role in preventing progression to end-stage renal disease (ESRD).