Interní Med. 2012; 14(5): 206-208

Treatment of lupus nephritis

doc.MUDr.Ivo Matl, CSc.

Klinika nefrologie, Institut klinické a experimentální medicíny, Praha

Lupus nephritis occurs in approximately 60 % of patients with systemic lupus etythematosus. Main manifestation patterns are proteinuria,

often associated with nephrotic syndrome, microscopic hematuria, and renal dysfunction. The treatment is directed by histopathological

finding in renal biopsy. In patients with class I and II, ACE inhibitors and angiotensin receptor blockers are indicated. In proliferative forms

of class III and IV, induction immunosuppression with corticosteroids and cyclophosphamide or mycophenolate mofetil is necessary.

Maintenance therapy with corticosteroids and mycophenolate mofetil or azathioprin follows after achievement of remission. Membranous

form of class V is in it´s pure form more benign, and at the beginning when symptoms are mild, symptomatic therapy might be sufficient.

Higher proteinuria or simultaneous histological finding of proliferation indicates combined immunosuppression as in proliferative forms.

In this indication, particularly when higher proteinuria is present, cyclosporin A is a method of choice.

Keywords: lupus nephritis, corticosteroids, cyclophoshamide, mycophenolate mofetil, cyclosporine A

Published: May 14, 2012  Show citation