TY - JOUR
TI - An Update on the Diagnosis and Management of Lupus Nephritis
AU - Kostopoulou, M.
AU - Adamichou, C.
AU - Bertsias, G.
JO - Current Rheumatology Reports
PY - 2020
VL - 22
TODO - 7
SP - null
PB - Springer-Verlag
SN - 1523-3774, 1534-6307
TODO - 10.1007/s11926-020-00906-7
TODO - biological product;  calcineurin inhibitor;  immunosuppressive agent;  cyclophosphamide;  monoclonal antibody;  mycophenolic acid, childhood disease;  diagnostic procedure;  disease burden;  drug efficacy;  drug safety;  early diagnosis;  end stage renal disease;  human;  immunosuppressive treatment;  kidney biopsy;  lupus erythematosus nephritis;  maintenance therapy;  patient care;  patient monitoring;  pregnancy disorder;  relapse;  Review, Antibodies, Monoclonal;  Calcineurin Inhibitors;  Cyclophosphamide;  Humans;  Immunosuppressive Agents;  Lupus Nephritis;  Mycophenolic Acid
TODO - Purpose of Review: Update on the diagnosis, treatment, and monitoring of lupus nephritis. Recent Findings: The recent criteria enable the earlier classification of lupus nephritis based on kidney biopsy and compatible serology. Treatment of active nephritis includes low-dose intravenous cyclophosphamide or mycophenolate, followed by maintenance immunosuppression. Recent trials have suggested superiority of regimens combining mycophenolate with either calcineurin inhibitor or belimumab, although their long-term benefit/risk ratio has not been determined. Encouraging results with novel anti-CD20 antibodies confirm the effectiveness of B cell depletion. Achievement of low-grade proteinuria (< 700–800 mg/24 h) at 12-month post-induction is linked to favorable long-term outcomes and could be considered in a treat-to-target strategy. Also, repeat kidney biopsy can guide the duration of maintenance immunosuppression. Lupus nephritis has increased cardiovascular disease burden necessitating risk-reduction strategies. Summary: An expanding spectrum of therapies coupled with ongoing basic/translational research can lead to individualized medical care and improved outcomes in lupus nephritis. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
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