The role of kidney biopsy in the management of lupus nephritis.
OBJECTIVE
This review evaluates the role of kidney biopsy as a tool in the diagnosis, prognostication and therapeutic management of lupus nephritis. The renal biopsy is the only method available for diagnosing and classifying lupus nephritis. However, disagreements persist regarding the appropriate role of a renal biopsy in the management and identification of predictors of short and long-term outcomes.


RESULTS
Recent modifications to the classification of lupus nephritis, the emergence of newer scoring indices, and the availability of a variety of therapeutic options predicate a reassessment of the role of the renal biopsy in the management of lupus nephritis, especially for high-risk patients.


CONCLUSIONS
Despite some controversy, the renal biopsy has been shown to provide information over and above that provided by the clinical variables, and remains a pivotal element in optimizing therapy and the rational management of lupus nephritis.
Mittal
Bharati
B
Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Rennke
Helmut
H
Singh
Ajay K
AK
D001707:Biopsy, Needle / Q000379:methods; D005069:Evaluation Studies as Topic; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008181:Lupus Nephritis / Q000145:classification* / Q000473:pathology / Q000628:therapy*; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index