From the Guidelines
Lupus nephritis symptoms include foamy urine, blood in urine, high blood pressure, swelling in legs, ankles, or around the eyes, and increased creatinine levels indicating kidney dysfunction, and the most effective treatment approach is a two-phase therapy with induction and maintenance phases, as recommended by the most recent guidelines 1.
Symptoms of Lupus Nephritis
- Foamy urine
- Blood in urine
- High blood pressure
- Swelling in legs, ankles, or around the eyes
- Increased creatinine levels indicating kidney dysfunction
Treatment Options
- Induction therapy: corticosteroids (prednisone 0.5-1 mg/kg/day) combined with immunosuppressants like mycophenolate mofetil (2-3 g/day) or cyclophosphamide (500-1000 mg/m² monthly), as recommended by the 2024 KDIGO guidelines 1
- Maintenance therapy: lower-dose corticosteroids and either mycophenolate mofetil (1-2 g/day) or azathioprine (1.5-2.5 mg/kg/day) for at least 3 years, as recommended by the 2020 EULAR/ERA-EDTA guidelines 1
- Supportive care: blood pressure control with ACE inhibitors or ARBs, which also help reduce protein leakage, and hydroxychloroquine (200-400 mg daily) to reduce flares, as recommended by the 2020 EULAR/ERA-EDTA guidelines 1
- Regular monitoring of kidney function, urine protein levels, and medication side effects is essential, as emphasized by the 2012 American College of Rheumatology guidelines 1
Treatment Effectiveness
- 60-80% of patients respond to initial therapy, though some may progress to end-stage renal disease requiring dialysis or transplantation despite treatment, as reported by the 2012 American College of Rheumatology guidelines 1
- Early diagnosis and aggressive treatment significantly improve outcomes by preventing permanent kidney damage, as highlighted by the 2020 EULAR/ERA-EDTA guidelines 1
From the Research
Symptoms of Lupus Nephritis
- The symptoms of lupus nephritis can vary from person to person, but common symptoms include:
- Proteinuria (excess protein in the urine)
- Hematuria (blood in the urine)
- Elevated serum creatinine levels
- Decreased kidney function
- Systemic symptoms such as fever, fatigue, and weight loss
Treatment Options for Lupus Nephritis
- The treatment of lupus nephritis typically involves immunosuppressive medications, such as:
- The choice of treatment depends on the severity of the disease and the patient's response to therapy
- Combination therapy with multiple immunosuppressive agents may be used in some cases 3, 4
Efficacy and Safety of Treatment Options
- MMF has been shown to be effective in treating lupus nephritis, with significant improvements in proteinuria and serum albumin levels 2
- Rituximab has been shown to be effective in inducing remission in patients with lupus nephritis, particularly in those with relapsing disease 4, 6
- Cyclophosphamide has been shown to be effective in treating lupus nephritis, but may be associated with more side effects than MMF or rituximab 2, 4, 6
- The safety and efficacy of combination therapy with multiple immunosuppressive agents is still being studied 3, 4