Beyond immunosuppression – challenges in the clinical management of lupus nephritis
- 1 February 2009
- journal article
- review article
- Published by SAGE Publications in Lupus
- Vol. 18 (2), 106-115
- https://doi.org/10.1177/0961203308095330
Abstract
Lupus nephritis remains the most common severe manifestation of SLE with increased risk of death and end-stage renal disease. Although, recent research has focused on the choice of immunosuppressive in its treatment, other factors, including the quality and delivery of healthcare, the management of glucocorticoids and co-morbidity are probably of more importance. There has been significant progress in induction regimes with the successful use of mycophenolate mofetil, low dose intravenous cyclophosphamide and development of sequential regimens whereby cyclophosphamide is followed by an alternative immunosuppressive. However, the attention on the day-to-day management of lupus nephritis in the clinic has merited less attention. In this article, we aim to address more widely the major issues which are encountered regularly in the long-term management of these patients. The overall goals are the reduction of mortality and preservation of renal function.This publication has 68 references indexed in Scilit:
- Angiotensin-converting enzyme inhibitors delay the occurrence of renal involvement and are associated with a decreased risk of disease activity in patients with systemic lupus erythematosus--results from LUMINA (LIX): a multiethnic US cohortRheumatology, 2008
- The Lipid lowering and Onset of Renal Disease (LORD) Trial: A randomized double blind placebo controlled trial assessing the effect of atorvastatin on the progression of kidney diseaseBMC Nephrology, 2008
- Effects of statins in patients with chronic kidney disease: meta-analysis and meta-regression of randomised controlled trialsBMJ, 2008
- Effect of a Multifactorial Intervention on Mortality in Type 2 DiabetesThe New England Journal of Medicine, 2008
- High prevalence of anti-C1q antibodies in biopsy-proven active lupus nephritisNephrology Dialysis Transplantation, 2006
- International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS)Journal of Thrombosis and Haemostasis, 2006
- How to monitor SLE in routine clinical practiceAnnals Of The Rheumatic Diseases, 2005
- Mycophenolate Mofetil in Pregnancy After Renal Transplantation: A Case of Major Fetal MalformationsObstetrics & Gynecology, 2004
- Renal artery stenosis in the antiphospholipid (Hughes) syndrome and hypertensionAnnals Of The Rheumatic Diseases, 2003
- Measurement of increases in anti‐double‐stranded dna antibody levels as a predictor of disease exacerbation in systemic lupus erythematosusArthritis & Rheumatism, 1990